| Keith M Rogers Dds Pc | |
|
55 S 63rd St Suite 1 Mesa AZ 85206-1605 | |
| (480) 830-5100 | |
| Not Available |
| Full Name | Keith M Rogers Dds Pc |
|---|---|
| Speciality | Dentist |
| Location | 55 S 63rd St, Mesa, Arizona |
| Authorized Official Name and Position | Keith Rogers (OWNER, DENTIST) |
| Authorized Official Contact | 4808305100 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Keith M Rogers Dds Pc 55 S 63rd St Suite 1 Mesa AZ 85206-1605 Ph: (480) 830-5100 | Keith M Rogers Dds Pc 55 S 63rd St Suite 1 Mesa AZ 85206-1605 Ph: (480) 830-5100 |
| NPI Number | 1093910739 |
|---|---|
| Provider Enumeration Date | 06/20/2007 |
| Last Update Date | 10/19/2020 |
| Medicare PECOS PAC ID | 2466872932 |
|---|---|
| Medicare Enrollment ID | O20201022000278 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1093910739 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 4750 (Arizona) | Primary |
| Provider Name | Keith M Rogers |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1063553386 PECOS PAC ID: 3375963846 Enrollment ID: I20201022000339 |
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