Provider Demographics
NPI:1437284486
Name:OLDROYD, STEPHEN B (DMD)
Entity Type:Individual
Prefix:
First Name:STEPHEN
Middle Name:B
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 1:1601 E MCANDREWS AVE
Mailing Address - Street 2:BLDG A
Mailing Address - City:MEDFORD
Mailing Address - State:OR
Mailing Address - Zip Code:97504
Mailing Address - Country:US
Mailing Address - Phone:541-776-6960
Mailing Address - Fax:541-734-2034
Practice Address - Street 1:1601 E MCANDREWS AVE
Practice Address - Street 2:BLDG A
Practice Address - City:MEDFORD
Practice Address - State:OR
Practice Address - Zip Code:97504
Practice Address - Country:US
Practice Address - Phone:541-776-6960
Practice Address - Fax:541-734-2034
Is Sole Proprietor?:No
Enumeration Date:2007-02-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR4541122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist