Provider Demographics
NPI:1578691366
Name:DUGGER, ROBERT S (DMDPC)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:S
Last Name:DUGGER
Suffix:
Gender:M
Credentials:DMDPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1750 BLANKENSHIP RD.
Mailing Address - Street 2:STE. 230
Mailing Address - City:WEST LINN
Mailing Address - State:OR
Mailing Address - Zip Code:97068-4116
Mailing Address - Country:US
Mailing Address - Phone:503-650-6599
Mailing Address - Fax:503-722-2865
Practice Address - Street 1:1750 BLANKENSHIP RD.
Practice Address - Street 2:STE. 230
Practice Address - City:WEST LINN
Practice Address - State:OR
Practice Address - Zip Code:97068-4116
Practice Address - Country:US
Practice Address - Phone:503-650-6599
Practice Address - Fax:503-722-2865
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR62661223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice