Provider Demographics
NPI:1528028503
Name:BIEDE, ROGER C II (DDS)
Entity Type:Individual
Prefix:DR
First Name:ROGER
Middle Name:C
Last Name:BIEDE
Suffix:II
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 1:1238 W ORANGE GROVE RD
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85704
Mailing Address - Country:US
Mailing Address - Phone:520-575-8800
Mailing Address - Fax:520-742-4120
Practice Address - Street 1:1238 W ORANGE GROVE RD
Practice Address - Street 2:SUITE 102
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85704-2950
Practice Address - Country:US
Practice Address - Phone:520-797-1240
Practice Address - Fax:520-742-3876
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-24
Last Update Date:2021-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZD19361223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice