Provider Demographics
NPI:1093848889
Name:BISBEY, ROGER SCOTT (DDS)
Entity Type:Individual
Prefix:DR
First Name:ROGER
Middle Name:SCOTT
Last Name:BISBEY
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1011 BEL AIR LN NW
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:MN
Mailing Address - Zip Code:55901-6992
Mailing Address - Country:US
Mailing Address - Phone:507-288-1188
Mailing Address - Fax:507-529-4065
Practice Address - Street 1:1011 BEL AIR LN NW
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:MN
Practice Address - Zip Code:55901-6992
Practice Address - Country:US
Practice Address - Phone:507-288-1188
Practice Address - Fax:507-529-4065
Is Sole Proprietor?:No
Enumeration Date:2007-03-13
Last Update Date:2007-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN105801223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice