Provider Demographics
NPI:1225632698
Name:ROYAL, DANA (RPH)
Entity Type:Individual
Prefix:
First Name:DANA
Middle Name:
Last Name:ROYAL
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:73 FORT EDDY RD
Mailing Address - Street 2:
Mailing Address - City:CONCORD
Mailing Address - State:NH
Mailing Address - Zip Code:03301-7405
Mailing Address - Country:US
Mailing Address - Phone:603-228-2121
Mailing Address - Fax:
Practice Address - Street 1:73 FORT EDDY RD
Practice Address - Street 2:
Practice Address - City:CONCORD
Practice Address - State:NH
Practice Address - Zip Code:03301-7405
Practice Address - Country:US
Practice Address - Phone:603-228-2121
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-11-25
Last Update Date:2020-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA23476183500000X
NH3059183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist