Talley, Rodger Dale
Talley, Rodger Dale is an sole proprietor health care provider with primary practice located at 4220 Texas Blvd , Texarkana TX 75503-3013. He recently has only one registered license in Dental Providers / Dentist, which is considered as his primary health care specialty. Talley, Rodger Dale can be contacted via phone (903) 793-7629.Contact Information
Primary practice address
4220 Texas Blvd
Texarkana TX 75503-3013
Phone: (903) 793-7629
Fax: (903) 792-9130
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / Dentist | 122300000X | 20410 | Texas |
Profile Details
| NPI number | 1942529375 |
|---|---|
| LBN Legal business name | Talley, Rodger Dale |
| Credentials | Doctor of Dental Surgery (DDS) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | May 25th, 2010 |
| Last updated | May 25th, 2010 - about 14 years 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 | 1942529375 | NPPES |
| Arkansas | MEDICAID | 121693608 |
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