Individual
MICHAEL ANTHONY ROGERS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1340 IMPERIAL BEACH BLVD STE 203, IMPERIAL BEACH, CA 91932-3046
(619) 429-1700
Mailing address
1340 IMPERIAL BEACH BLVD STE 203, IMPERIAL BEACH, CA 91932-3046
(619) 429-1700
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
39074
CA
Other
Enumeration date
10/24/2006
Last updated
07/08/2007
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