Provider Demographics
NPI:1659457968
Name:ELVER, ROGER L (DDS)
Entity type:Individual
Prefix:DR
First Name:ROGER
Middle Name:L
Last Name:ELVER
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:185 W PINE ST
Mailing Address - Street 2:
Mailing Address - City:PLATTEVILLE
Mailing Address - State:WI
Mailing Address - Zip Code:53818-3113
Mailing Address - Country:US
Mailing Address - Phone:608-348-2745
Mailing Address - Fax:
Practice Address - Street 1:185 W PINE ST
Practice Address - Street 2:
Practice Address - City:PLATTEVILLE
Practice Address - State:WI
Practice Address - Zip Code:53818-3113
Practice Address - Country:US
Practice Address - Phone:608-348-2745
Practice Address - Fax:608-348-6885
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI50013471223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice