Provider Demographics
NPI:1043234396
Name:ROY, RICHARD MICHAEL (DDS)
Entity Type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:MICHAEL
Last Name:ROY
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:103 MAIN ST.
Mailing Address - Street 2:
Mailing Address - City:WILTON
Mailing Address - State:HI
Mailing Address - Zip Code:03086
Mailing Address - Country:US
Mailing Address - Phone:603-654-2555
Mailing Address - Fax:603-654-9797
Practice Address - Street 1:103 MAIN ST.
Practice Address - Street 2:
Practice Address - City:WILTON
Practice Address - State:NH
Practice Address - Zip Code:03086
Practice Address - Country:US
Practice Address - Phone:603-654-2555
Practice Address - Fax:603-654-9797
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH18891223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice