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Individual

SARA R ROGERS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
112 FAIRFIELD HILL ROAD, BLOOMFIELD, KY 40008-0484
(502) 252-0056
(502) 252-0058
Mailing address
PO BOX 484, 112 FAIRFIELD HILL ROAD, BLOOMFIELD, KY 40008-0484
(502) 252-0056
(502) 252-0058

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
8867
KY
1223G0001X
General Practice Dentistry
Primary
8867
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
7100139410
KY
Enumeration date
06/08/2010
Last updated
05/03/2016
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