| Jeff L. Rodgers, Dmd, Pc | |
|
1719 Mount Vernon Rd Suite A Dunwoody GA 30338-4268 | |
| (770) 394-4310 | |
| Not Available |
| Full Name | Jeff L. Rodgers, Dmd, Pc |
|---|---|
| Speciality | Dentist |
| Location | 1719 Mount Vernon Rd, Dunwoody, Georgia |
| Authorized Official Name and Position | Jeff Rodgers (OWNER) |
| Authorized Official Contact | 7703944310 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Jeff L. Rodgers, Dmd, Pc 1719 Mount Vernon Rd Suite A Dunwoody GA 30338-4268 Ph: () - | Jeff L. Rodgers, Dmd, Pc 1719 Mount Vernon Rd Suite A Dunwoody GA 30338-4268 Ph: (770) 394-4310 |
| NPI Number | 1518302165 |
|---|---|
| Provider Enumeration Date | 05/08/2013 |
| Last Update Date | 05/08/2013 |
| Medicare PECOS PAC ID | 7012142128 |
|---|---|
| Medicare Enrollment ID | O20201208000102 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1518302165 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 011381 (Georgia) | Primary |
| 332BC3200X | Durable Medical Equipment & Medical Supplies - Customized Equipment | (* (Not Available)) | Secondary |
| Provider Name | Jeff Rodgers |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1124175716 PECOS PAC ID: 3476788589 Enrollment ID: I20201208000310 |
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