Provider Demographics
NPI:1609812726
Name:ROY A MCDONALD DDS PC
Entity Type:Organization
Organization Name:ROY A MCDONALD DDS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ROY
Authorized Official - Middle Name:A
Authorized Official - Last Name:MCDONALD
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:770-667-6453
Mailing Address - Street 1:3005 ROYAL BLVD S
Mailing Address - Street 2:SUITE 250
Mailing Address - City:ALPHARETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30022-1421
Mailing Address - Country:US
Mailing Address - Phone:770-667-7340
Mailing Address - Fax:
Practice Address - Street 1:3005 ROYAL BLVD S
Practice Address - Street 2:SUITE 250
Practice Address - City:ALPHARETTA
Practice Address - State:GA
Practice Address - Zip Code:30022-1421
Practice Address - Country:US
Practice Address - Phone:770-667-7340
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-20
Last Update Date:2015-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA97551223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty