Provider Demographics
NPI:1346471075
Name:SMITH & ROY DENTISTRY PARTNERSHIP-DR. JEFF ROY
Entity Type:Organization
Organization Name:SMITH & ROY DENTISTRY PARTNERSHIP-DR. JEFF ROY
Other - Org Name:21ST CENTURY DENTAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:D.D.S.
Authorized Official - Prefix:
Authorized Official - First Name:ROY
Authorized Official - Middle Name:
Authorized Official - Last Name:JEFF
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:972-255-3712
Mailing Address - Street 1:4301 N MACARTHUR BLVD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:IRVING
Mailing Address - State:TX
Mailing Address - Zip Code:75038-6497
Mailing Address - Country:US
Mailing Address - Phone:972-255-3712
Mailing Address - Fax:
Practice Address - Street 1:4301 N MACARTHUR BLVD
Practice Address - Street 2:SUITE 100
Practice Address - City:IRVING
Practice Address - State:TX
Practice Address - Zip Code:75038-6497
Practice Address - Country:US
Practice Address - Phone:972-255-3712
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-07-29
Last Update Date:2009-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX187581223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty