Provider Demographics
NPI:1760657902
Name:ROEH, DEBORAH LEIGH (DDS)
Entity Type:Individual
Prefix:DR
First Name:DEBORAH
Middle Name:LEIGH
Last Name:ROEH
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1022 U ST NW
Mailing Address - Street 2:
Mailing Address - City:AUBURN
Mailing Address - State:WA
Mailing Address - Zip Code:98001-3825
Mailing Address - Country:US
Mailing Address - Phone:253-939-3554
Mailing Address - Fax:
Practice Address - Street 1:1022 U ST NW
Practice Address - Street 2:
Practice Address - City:AUBURN
Practice Address - State:WA
Practice Address - Zip Code:98001-3825
Practice Address - Country:US
Practice Address - Phone:253-939-3554
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-29
Last Update Date:2008-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA7938122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist