Individual
NICOLE ROGERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
612 WINDING CREEK RD, FAYETTEVILLE, NC 28305-5723
(317) 997-2226
Mailing address
718 E 52ND ST, INDIANAPOLIS, IN 46205-1120
(317) 997-2226
Taxonomy
Speciality
Code
Description
License number
State
1223P0300X
Periodontics
Primary
13172
NC
Other
Enumeration date
04/13/2023
Last updated
04/13/2023
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