| R Scott Roberts Dds Pc | |
|
3500 Cedar St North Bend OR 97459-1108 | |
| (541) 756-0558 | |
| (541) 756-1974 |
| Full Name | R Scott Roberts Dds Pc |
|---|---|
| Speciality | Dentist |
| Location | 3500 Cedar St, North Bend, Oregon |
| Authorized Official Name and Position | R Scott Roberts (OWNER) |
| Authorized Official Contact | 5417560558 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| R Scott Roberts Dds Pc 3500 Cedar St North Bend OR 97459-1108 Ph: (541) 756-0558 | R Scott Roberts Dds Pc 3500 Cedar St North Bend OR 97459-1108 Ph: (541) 756-0558 |
| NPI Number | 1659479095 |
|---|---|
| Provider Enumeration Date | 09/20/2006 |
| Last Update Date | 08/22/2020 |
| Medicare PECOS PAC ID | 4082614144 |
|---|---|
| Medicare Enrollment ID | O20070115000049 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1659479095 | NPI | - | NPPES |
| 297175 | Medicaid | OR | |
| D7517 | Other | OR | DENTAL LICENSE # |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223S0112X | Dentist - Oral And Maxillofacial Surgery | D7517 (Oregon) | Primary |
| Provider Name | Richard S Roberts |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1154319176 PECOS PAC ID: 0244230423 Enrollment ID: I20070111000686 |
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