Individual
DR. RODNEY J VERGOTINE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS-PEDIATRIC
Contact information
Practice address
1011 N UNIVERSITY AVE, ANN ARBOR, MI 48109-1078
(734) 764-8451
Mailing address
1011 N UNIVERSITY AVE, ANN ARBOR, MI 48109-1078
(734) 764-8451
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
019024428
IL
1223P0221X
Pediatric Dentistry
Primary
2901022954
MI
1223P0221X
Pediatric Dentistry
5438-015
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
019024428
—
IL
Enumeration date
09/07/2005
Last updated
09/02/2021
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