Individual
ROGER DONALD DIMICK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
11565 SW HALL BLVD STE C, TIGARD, OR 97223-8493
(503) 670-7088
(503) 443-1448
Mailing address
5060 GREENSBOROUGH CT, LAKE OSWEGO, OR 97035-8748
(503) 670-7088
(503) 443-1448
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
4319
OR
Other
Enumeration date
11/02/2006
Last updated
07/08/2007
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