Provider Demographics
NPI:1881601573
Name:ROGERS, STANLEY GRAY (DDS)
Entity type:Individual
Prefix:DR
First Name:STANLEY
Middle Name:GRAY
Last Name:ROGERS
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:412 E WILLIAMS ST
Mailing Address - Street 2:STE D
Mailing Address - City:APEX
Mailing Address - State:NC
Mailing Address - Zip Code:27502
Mailing Address - Country:US
Mailing Address - Phone:919-362-5777
Mailing Address - Fax:919-367-8561
Practice Address - Street 1:412 E WILLIAMS ST
Practice Address - Street 2:STE D
Practice Address - City:APEX
Practice Address - State:NC
Practice Address - Zip Code:27502
Practice Address - Country:US
Practice Address - Phone:919-362-5777
Practice Address - Fax:919-367-8561
Is Sole Proprietor?:No
Enumeration Date:2006-08-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC4015122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist