Provider Demographics
NPI:1780350918
Name:ROGERS, AARON REID (DMD)
Entity type:Individual
Prefix:DR
First Name:AARON
Middle Name:REID
Last Name:ROGERS
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:781 NE 7TH ST STE 1A
Mailing Address - Street 2:
Mailing Address - City:GRANTS PASS
Mailing Address - State:OR
Mailing Address - Zip Code:97526-1654
Mailing Address - Country:US
Mailing Address - Phone:541-474-5001
Mailing Address - Fax:
Practice Address - Street 1:781 NE 7TH ST STE 1A
Practice Address - Street 2:
Practice Address - City:GRANTS PASS
Practice Address - State:OR
Practice Address - Zip Code:97526-1654
Practice Address - Country:US
Practice Address - Phone:541-474-5001
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-08-18
Last Update Date:2021-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORD115061223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice