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1821053521
ROGER BRENT LAWRENCE
PORTLAND, OR
NPI
1821053521
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
1223G0001X Dentist, General Practice
(Licence: OR D6374)
Enumeration Date
2006-04-18
Last Update Date
2007-07-08
Business Address
Dr. ROGER BRENT LAWRENCE DMD
5415 SW WESTGATE DR SUITE 206
PORTLAND, OR 97221-2409
Phone number: 503-292-1173
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Mailing Address
Dr. ROGER BRENT LAWRENCE DMD
5415 SW WESTGATE DR SUITE 206
PORTLAND, OR 97221-2409
Phone number: 503-292-1173
Copy
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