Provider Demographics
NPI:1093745176
Name:ROYER, MARIAN ANN (DMD)
Entity Type:Individual
Prefix:
First Name:MARIAN
Middle Name:ANN
Last Name:ROYER
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2765 E MAIN RD
Mailing Address - Street 2:BOX 810
Mailing Address - City:PORTSMOUTH
Mailing Address - State:RI
Mailing Address - Zip Code:02871-2605
Mailing Address - Country:US
Mailing Address - Phone:401-683-9724
Mailing Address - Fax:401-683-0295
Practice Address - Street 1:2765 E MAIN RD
Practice Address - Street 2:BOX 810
Practice Address - City:PORTSMOUTH
Practice Address - State:RI
Practice Address - Zip Code:02871-2605
Practice Address - Country:US
Practice Address - Phone:401-683-9724
Practice Address - Fax:401-683-0295
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RI25361223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice