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Randall Scott Clasen, LD
Denturist in Roseburg, Oregon
NPI 1235570961

Randall Scott Clasen is a Denturist based in Roseburg, OR. Randall Scott Clasen practices in Roseburg, OR and has the professional credentials of LD. The NPI Number for Randall Scott Clasen is 1235570961 and holds a License No. DTDO355212 (Oregon).

The current practice location address for Randall Scott Clasen is 696 Ne Winchester St, Roseburg, OR and can be reached out via phone at 541-673-2724 and via fax at 547-440-6906.

Location: 696 Ne Winchester St, Roseburg, OR, 97470-3260
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1235570961
Provider Name
Randall Scott Clasen
Credential
LD
Provider Entity Type
Individual
Gender
Male
Address
696 Ne Winchester St, Roseburg, OR, 97470-3260
Phone Number
541-673-2724
Fax Number
547-440-6906
Provider Enumeration Date
07/10/2013
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
86-114979 01 OR TAX ID
institution
Provider Business Practice Location Address Details
Address
696 Ne Winchester St
City
Roseburg
State
Oregon
Zip
97470-3260
Phone Number
541-673-2724
Fax Number
547-440-6906
person
Provider Business Mailing Address Details
Address
696 Ne Winchester St
City
Roseburg
State
Oregon
Zip
97470-3260
Phone Number
541-673-2724
Fax Number
547-440-6906
person
Provider's Taxonomy Details 1
Type
Dental Providers
Classification
Denturist
Speciality
-
Taxonomy
122400000X
License No.
DTDO355212 (Oregon)
Definition
Definition to come.
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