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General NPI Number Information
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NPI Number | 1942551791
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Entity Type | Organization
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Legal Business Name | ROGER C. DOW, DMD PC
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Dates
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Enumeration Date | 09/19/2012
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Last Update Date | 09/19/2012
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Provider Practice Location Address
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Address Line | 140 RAMSGATE SQ SE SUITE 110
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City | SALEM
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State | OR
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Zip | 97302
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Country | US
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Telephone | 503-363-1712
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Fax | 503-363-4346
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Provider Business Mailing Address
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Address Line | 140 RAMSGATE SQ SE SUITE 110
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City | SALEM
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State | OR
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Zip | 97302
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Country | US
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Telephone | 503-363-1712
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Fax | 503-363-4346
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Authorized Official
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Title or Position | DENTIST/OWNER
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Name | DR. ROGER C DOW
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Credential | D.M.D.
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Telephone | 503-363-1712
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number | D6497
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License Number State | OR
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