Individual
JACK LIAM ROGAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
351 W 6TH STREET, FORT STEWART, GA 31314
(912) 435-9185
Mailing address
615 MONTGOMERY ST APT 131, SAVANNAH, GA 31401-5405
(314) 914-4227
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
10510
SC
Other
Enumeration date
06/19/2023
Last updated
09/18/2024
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