Provider Demographics
NPI:1659569499
Name:ROGER D.SOHN DDS
Entity Type:Organization
Organization Name:ROGER D.SOHN DDS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ROGER
Authorized Official - Middle Name:D
Authorized Official - Last Name:SOHN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:909-478-9777
Mailing Address - Street 1:24950 REDLANDS BLVD
Mailing Address - Street 2:SUITE B
Mailing Address - City:LOMA LINDA
Mailing Address - State:CA
Mailing Address - Zip Code:92354-4032
Mailing Address - Country:US
Mailing Address - Phone:909-478-9777
Mailing Address - Fax:909-478-9779
Practice Address - Street 1:24950 REDLANDS BLVD
Practice Address - Street 2:SUITE B
Practice Address - City:LOMA LINDA
Practice Address - State:CA
Practice Address - Zip Code:92354-4032
Practice Address - Country:US
Practice Address - Phone:909-478-9777
Practice Address - Fax:909-478-9779
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-05
Last Update Date:2007-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental