Provider Demographics
NPI:1639265028
Name:ROYER, GEORGE MILES (DMD)
Entity Type:Individual
Prefix:DR
First Name:GEORGE
Middle Name:MILES
Last Name:ROYER
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 1:3737 POPLAR AVE
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15234-2155
Mailing Address - Country:US
Mailing Address - Phone:412-531-7393
Mailing Address - Fax:412-341-2187
Practice Address - Street 1:3737 POPLAR AVE
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15234-2155
Practice Address - Country:US
Practice Address - Phone:412-531-7393
Practice Address - Fax:412-341-2187
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS026352L1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA522906OtherUCCI IDENTIFICATION NUMBE