Organization
THEODORA KK ROGERS, DDS, PC
Active
Other names
Gray Duck Dentistry
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TEDDY KK ROGERS DDS (DIRECTOR)
(816) 572-1973
Entity
Organization
Contact information
Practice address
1000 BLUFF ST, FULTON, MO 65251-2321
(573) 642-7234
Mailing address
505 PREAKNESS DR, RAYMORE, MO 64083-8472
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
07/13/2016
Last updated
07/13/2016
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