Individual
NAOMI C ROEDER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
200 W. HOSPITAL DRIVE, WHITERIVER, AZ 85941
(928) 338-3615
Mailing address
PO BOX 4104, PINETOP, AZ 85935-4104
(928) 367-3305
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
D6141
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
092403
WHITERIVER
—
01
—
092461
CBQ
—
05
—
931586
—
AZ
Enumeration date
04/09/2007
Last updated
02/05/2014
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