Individual
DR. BRAD ROGERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
201 N STATE ST, OREM, UT 84057-4745
(801) 225-7712
(801) 225-2174
Mailing address
201 N STATE ST, OREM, UT 84057-4745
(801) 225-7712
(801) 225-2174
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
8080001-9922
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1033164108
—
UT
Enumeration date
08/13/2012
Last updated
08/13/2012
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