Provider Demographics
NPI:1578776548
Name:ATKIN, ROY DAVID (DDS, MS)
Entity Type:Individual
Prefix:DR
First Name:ROY
Middle Name:DAVID
Last Name:ATKIN
Suffix:
Gender:M
Credentials:DDS, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3565 TRIESTE DR
Mailing Address - Street 2:
Mailing Address - City:CARLSBAD
Mailing Address - State:CA
Mailing Address - Zip Code:92010-2840
Mailing Address - Country:US
Mailing Address - Phone:760-729-5326
Mailing Address - Fax:
Practice Address - Street 1:3565 TRIESTE DR
Practice Address - Street 2:
Practice Address - City:CARLSBAD
Practice Address - State:CA
Practice Address - Zip Code:92010-2840
Practice Address - Country:US
Practice Address - Phone:760-729-5326
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA187771223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics