Provider Demographics
NPI:1407456031
Name:ROGER RYAN ROYBAL DDS PLLC
Entity Type:Organization
Organization Name:ROGER RYAN ROYBAL DDS PLLC
Other - Org Name:RESTFUL DENTAL SLEEP CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT/DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:ROGER
Authorized Official - Middle Name:RYAN
Authorized Official - Last Name:ROYBAL
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:602-525-4486
Mailing Address - Street 1:14300 N NORTHSIGHT BLVD STE 214
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85260-3677
Mailing Address - Country:US
Mailing Address - Phone:602-525-4486
Mailing Address - Fax:602-733-6485
Practice Address - Street 1:14300 N NORTHSIGHT BLVD STE 214
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85260-3677
Practice Address - Country:US
Practice Address - Phone:602-525-4486
Practice Address - Fax:602-733-6485
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-11-01
Last Update Date:2020-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty
No332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized EquipmentGroup - Single Specialty