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Organization

SHAWN M. RODGERS, DDS, PLLC

Active
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Organization

SHAWN M. RODGERS, DDS, PLLC

Active
Other names
Uptown Park Dental
Organization subpart
No

Provider details

NPI number
Authorized official
DOMINIQUE D RODGERS (PRACTICE ADMINSTRATOR)
(713) 621-4830
Entity
Organization

Contact information

Practice address
1121 UPTOWN PARK BLVD STE 19, HOUSTON, TX 77056-3226
(713) 621-4830
(713) 621-6261
Mailing address
1121 UPTOWN PARK BLVD STE 19, HOUSTON, TX 77056-3226
(713) 621-4830
(713) 621-6261

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
24061
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1223G0001X
GENERAL DENTISTRY
TX
01
—
24061
DENTAL LICENSE
TX
Enumeration date
01/13/2015
Last updated
01/13/2015
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