Individual
R. SCOTT ROBERTS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS PC
Contact information
Practice address
3500 CEDAR ST, NORTH BEND, OR 97459-1108
(541) 756-0558
(541) 756-1974
Mailing address
3500 CEDAR ST, NORTH BEND, OR 97459-1108
(541) 756-0558
(541) 756-1974
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
D7517
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
297175
—
OR
01
—
D7517
DENTAL LICENSE #
OR
Enumeration date
10/13/2005
Last updated
07/08/2007
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