Individual
DR. BRUCE WALTER ROMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
500 SE DOUGLAS AVE, ROSEBURG, OR 97470-3120
(541) 672-5721
(541) 672-7663
Mailing address
PO BOX 609, WINCHESTER, OR 97495-0609
(541) 672-7100
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
23754
CA
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
D8534
OR
Other
Enumeration date
01/31/2007
Last updated
07/26/2011
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