Provider Demographics
NPI:1053480368
Name:OLDROYD, ROGER J (DDS MSP)
Entity Type:Individual
Prefix:DR
First Name:ROGER
Middle Name:J
Last Name:OLDROYD
Suffix:
Gender:M
Credentials:DDS MSP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:490 NORTH MAIN
Mailing Address - Street 2:
Mailing Address - City:RICHFIELD
Mailing Address - State:UT
Mailing Address - Zip Code:84701
Mailing Address - Country:US
Mailing Address - Phone:435-896-4053
Mailing Address - Fax:435-896-1950
Practice Address - Street 1:490 NORTH MAIN
Practice Address - Street 2:
Practice Address - City:RICHFIELD
Practice Address - State:UT
Practice Address - Zip Code:84701
Practice Address - Country:US
Practice Address - Phone:435-896-4053
Practice Address - Fax:435-896-1950
Is Sole Proprietor?:No
Enumeration Date:2006-11-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT25651223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics