Provider Demographics
NPI:1922982388
Name:JEFF L. RODGERS, DMD, PC
Entity type:Organization
Organization Name:JEFF L. RODGERS, DMD, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:CATHY
Authorized Official - Middle Name:
Authorized Official - Last Name:DALY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:770-394-4310
Mailing Address - Street 1:1719 MOUNT VERNON RD
Mailing Address - Street 2:
Mailing Address - City:DUNWOODY
Mailing Address - State:GA
Mailing Address - Zip Code:30338-4268
Mailing Address - Country:US
Mailing Address - Phone:770-394-4310
Mailing Address - Fax:
Practice Address - Street 1:1690 STONE VILLAGE LN NW STE 1000
Practice Address - Street 2:
Practice Address - City:KENNESAW
Practice Address - State:GA
Practice Address - Zip Code:30152-7714
Practice Address - Country:US
Practice Address - Phone:770-288-5991
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-07-31
Last Update Date:2025-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment