Provider Demographics
NPI:1952561276
Name:BARTELS, ROGER (DDS)
Entity Type:Individual
Prefix:DR
First Name:ROGER
Middle Name:
Last Name:BARTELS
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 1:138 MATHESON ST
Mailing Address - Street 2:
Mailing Address - City:HEALDSBURG
Mailing Address - State:CA
Mailing Address - Zip Code:95448-4118
Mailing Address - Country:US
Mailing Address - Phone:707-433-8888
Mailing Address - Fax:707-433-8220
Practice Address - Street 1:138 MATHESON ST
Practice Address - Street 2:
Practice Address - City:HEALDSBURG
Practice Address - State:CA
Practice Address - Zip Code:95448-4118
Practice Address - Country:US
Practice Address - Phone:707-433-8888
Practice Address - Fax:707-433-8220
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-10
Last Update Date:2008-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA36520122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist