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NPI Code Detail

MEDICARE: ROGER CARL BIEDE II DDS LTD

MEDICARE: ROGER CARL BIEDE II DDS LTD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11223G0001XGeneral Practice Dentistry1936AZ

General Provider Information

NPI Number : 1790083566
Entity Type Code : Organization
Provider Name (Legal Business Name) : ROGER CARL BIEDE II DDS LTD
Provider Business Mailing Address
First Line : 1238 W ORANGE GROVE RD
Second Line : SUITE 102
City : TUCSON
State : AZ
Zip : 85704-2950
Country : US
Telephone Number : 520-797-1240
Fax Number : 520-797-1240
Provider Business Practice Location Address
First Line : 1238 W ORANGE GROVE RD
Second Line : SUITE 102
City : TUCSON
State : AZ
Zip : 85704-2950
Country : US
Telephone Number : 520-797-1240
Fax Number : 520-797-1240
Authorized Official
Title or Position : DENTIST
Name : DR. ROGER CARL BIEDE II
Credential : DDS
Telephone Number : 520-797-1240
Provider Enumeration Date : 03/03/2011
Last Update Date : 09/14/2011

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