Individual
SOPHIE ROSE DIEPENHEIM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
61583 SE 27TH ST STE 170, BEND, OR 97702-8863
(541) 262-6101
(541) 623-0610
Mailing address
548 NW HARMON BLVD, BEND, OR 97703-3022
(541) 419-6567
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
D10924
OR
Other
Enumeration date
08/22/2018
Last updated
12/18/2024
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