Provider Demographics
NPI:1073810941
Name:CHRISTIAN, ROY PAUL (DDS)
Entity Type:Individual
Prefix:DR
First Name:ROY
Middle Name:PAUL
Last Name:CHRISTIAN
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 1:990 W FREMONT AVE STE U2
Mailing Address - Street 2:
Mailing Address - City:SUNNYVALE
Mailing Address - State:CA
Mailing Address - Zip Code:94087-3065
Mailing Address - Country:US
Mailing Address - Phone:408-738-1645
Mailing Address - Fax:
Practice Address - Street 1:990 W FREMONT AVE
Practice Address - Street 2:
Practice Address - City:SUNNYVALE
Practice Address - State:CA
Practice Address - Zip Code:94087-3021
Practice Address - Country:US
Practice Address - Phone:408-738-1645
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-02-11
Last Update Date:2011-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA036212122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist