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Individual

DR. CLINT A ROGERS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
DMD

Contact information

Practice address
189 SW CAPTAIN BROWN RD, MADISON, FL 32340-4351
(850) 973-6621
(850) 973-6672
Mailing address
2377 SW COUNTY ROAD 360A, MADISON, FL 32340-8414
(850) 973-6621
(850) 973-6672

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DN15232
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
070387700
FL
Enumeration date
04/25/2007
Last updated
05/10/2012
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