Provider Demographics
NPI:1265671788
Name:OLDROYD, ALEXANDER RAY (DMD)
Entity Type:Individual
Prefix:MR
First Name:ALEXANDER
Middle Name:RAY
Last Name:OLDROYD
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1051 WEST PEARCE BOULEVARD
Mailing Address - Street 2:
Mailing Address - City:WENTZVILLE
Mailing Address - State:MO
Mailing Address - Zip Code:63385-1019
Mailing Address - Country:US
Mailing Address - Phone:636-332-2350
Mailing Address - Fax:636-332-1357
Practice Address - Street 1:1051 WEST PEARCE BOULEVARD
Practice Address - Street 2:
Practice Address - City:WENTZVILLE
Practice Address - State:MO
Practice Address - Zip Code:63385-1019
Practice Address - Country:US
Practice Address - Phone:636-332-2350
Practice Address - Fax:636-332-1357
Is Sole Proprietor?:No
Enumeration Date:2009-02-05
Last Update Date:2024-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL021.0028471223X0400X
MO20100063101223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics