Provider Demographics
NPI:1689895062
Name:FRENCH, RAYMOND LESLIE (DMD)
Entity Type:Individual
Prefix:DR
First Name:RAYMOND
Middle Name:LESLIE
Last Name:FRENCH
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:470 HIGHLAND AVE
Mailing Address - Street 2:
Mailing Address - City:COOS BAY
Mailing Address - State:OR
Mailing Address - Zip Code:97420-2243
Mailing Address - Country:US
Mailing Address - Phone:541-269-2100
Mailing Address - Fax:
Practice Address - Street 1:470 HIGHLAND AVE
Practice Address - Street 2:
Practice Address - City:COOS BAY
Practice Address - State:OR
Practice Address - Zip Code:97420-2243
Practice Address - Country:US
Practice Address - Phone:541-269-2100
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR50441223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice