Individual
JOHN MARK RODGERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
33 HOSPITAL DR, LAKELAND, GA 31635-5716
(229) 482-1100
Mailing address
11297 89TH RD, LIVE OAK, FL 32060-7138
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DN123125
GA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/26/2023
Last updated
06/26/2023
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