Pearson, Roger
Pearson, Roger is an individual health care provider with primary practice located at 1200 W State St , Rockford IL 61102-2112. He recently has only one registered license in Dental Providers / General Practice, which is considered as his primary health care specialty. Pearson, Roger can be contacted via phone (815) 490-1600.Contact Information
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / General Practice | 1223G0001X | Illinois |
Profile Details
| NPI number | 1104809177 |
|---|---|
| LBN Legal business name | Pearson, Roger |
| Credentials | Doctor of Dental Surgery (DDS) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Nov 23rd, 2005 |
| Last updated | Jun 10th, 2024 - about 3 months ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1104809177 | NPPES |
| Illinois | Other | 1003292 | DOREL |
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