| Organization Name: | STEPHEN A. RODGERS, DMD, PLLC |
| NPI Number: | 1043573603 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | STEPHEN A. RODGERS (MANAGING MEMBER) |
| Mailing Address: | 13515 Ne 175th St Ste C Woodinville |
| State: | WA US |
| Postal Code: | 980728566 |
| Phone Number: | 4254839000 |
| Fax Number: | 4254816089 |
| NPI Enumeration Date: | 06/19/2012 |
| NPI Last Update Date: | 06/19/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QD0000X |
| License Number: | DE 60149420 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | WA |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Dental |
| Taxonomy Definition: | |