Provider Demographics
NPI:1245390772
Name:MARGENAU, ROY EDGAR III (DDS)
Entity Type:Individual
Prefix:DR
First Name:ROY
Middle Name:EDGAR
Last Name:MARGENAU
Suffix:III
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 1:3411 CENTRAL ST
Mailing Address - Street 2:
Mailing Address - City:DEXTER
Mailing Address - State:MI
Mailing Address - Zip Code:48130-1023
Mailing Address - Country:US
Mailing Address - Phone:734-426-2692
Mailing Address - Fax:734-426-8727
Practice Address - Street 1:3411 CENTRAL ST
Practice Address - Street 2:
Practice Address - City:DEXTER
Practice Address - State:MI
Practice Address - Zip Code:48130-1023
Practice Address - Country:US
Practice Address - Phone:734-426-2692
Practice Address - Fax:734-426-8727
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI14869122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist