Provider Demographics
NPI:1194806661
Name:FRENCH, ROGER M (DMD)
Entity type:Individual
Prefix:DR
First Name:ROGER
Middle Name:M
Last Name:FRENCH
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1885 WAITE ST
Mailing Address - Street 2:
Mailing Address - City:NORTH BEND
Mailing Address - State:OR
Mailing Address - Zip Code:97459-1210
Mailing Address - Country:US
Mailing Address - Phone:541-756-1117
Mailing Address - Fax:541-756-3811
Practice Address - Street 1:1885 WAITE ST
Practice Address - Street 2:
Practice Address - City:NORTH BEND
Practice Address - State:OR
Practice Address - Zip Code:97459-1210
Practice Address - Country:US
Practice Address - Phone:541-756-1117
Practice Address - Fax:541-756-3811
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR51721223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice