Individual
ROGER LUNT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
11982 NE GLISAN ST, PORTLAND, OR 97220-2143
(503) 257-8787
Mailing address
11982 NE GLISAN ST, PORTLAND, OR 97220-2143
(503) 257-8787
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
D5019
OR
Other
Enumeration date
04/20/2007
Last updated
07/08/2007
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