OrganizationDr. Roger C. Stoddard Dds, PaClinic/CenterAmbulatory Health Care FacilitiesPractice Address2480 White Bear Ave N Ste 202, Maplewood, MN 55109-4567(651) 776-1597PECOS EnrollmentBased on the most recent information from CMS, provider Dr. Roger C. Stoddard Dds, Pa does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records 2 days ago.Profile DetailsProvider ID1225640865Provider TypeOrganizationFull NameDr. Roger C. Stoddard Dds, PaSubpartNoEnumeration Date8/17/2020Last Updated8/17/2020Contact InformationPractice LocationPractice Address2480 White Bear Ave N Ste 202, Maplewood, MN 55109-4567Phone(651) 776-1597FaxUnlisted FaxMailing LocationMailing Address2480 White Bear Ave N Ste 202, Maplewood, MN 55109-4567PhoneUnlisted PhoneFaxUnlisted FaxAuthorized OfficialNameStoddard, Roger Charles (Dentist/Owner)Phone(651) 776-1597Provider TaxonomiesCodeDescriptionLicenseCode261QD0000XPrimaryDescriptionClinic/CenterAmbulatory Health Care FacilitiesLicenseUnlisted Issuer