Individual
DR. MATTHEW DALE ROGERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
945 MAIN ST STE 101, MANCHESTER, CT 06040-6064
(860) 646-1704
Mailing address
300 COLT HWY APT 6, FARMINGTON, CT 06032-3070
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
009626
CT
Other
Enumeration date
02/02/2007
Last updated
07/08/2007
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