Organization
R SCOTT ROBERTS DDS PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
R SCOTT ROBERTS DDS (OWNER)
(541) 756-0558
Entity
Organization
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
09/20/2006
Last updated
08/22/2020
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