Individual
DR. ROGER LEE NORTHEN JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
1001 CENTRE AVE, FORT COLLINS, CO 80526-6047
(970) 407-1001
(970) 407-1581
Mailing address
1001 CENTRE AVE, FORT COLLINS, CO 80526-6047
(970) 407-1001
(970) 407-1581
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
HD105225
CO
Other
Enumeration date
07/21/2006
Last updated
07/08/2007
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