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Individual

KRISTEN ROGERS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
DDS

Contact information

Practice address
1075 CENTRAL PARK AVE STE 207, SCARSDALE, NY 10583-3250
(914) 472-5252
Mailing address
22 NORTHGATE CIR, MELVILLE, NY 11747-3037
(516) 312-6411

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
062800
NY
122300000X
Dentist
24394
FL
122300000X
Dentist
DN24394
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
062800
LICENSE
NY
01
24394
LICENSE
FL
Enumeration date
09/19/2022
Last updated
10/12/2022
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