Individual
BLAKE R ROGERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
41 WORCESTER SQ, APT 6, BOSTON, MA 02118-2919
(509) 868-4225
Mailing address
41 WORCESTER SQ, APT 6, BOSTON, MA 02118-2919
(509) 868-4225
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DN1857206
MA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
07/16/2013
Last updated
01/10/2017
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