Provider Demographics
NPI:1659359339
Name:DAY, ROY E (DDS)
Entity Type:Individual
Prefix:DR
First Name:ROY
Middle Name:E
Last Name:DAY
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3000 HAMPTON CTR
Mailing Address - Street 2:SUITE B
Mailing Address - City:MORGANTOWN
Mailing Address - State:WV
Mailing Address - Zip Code:26505-1708
Mailing Address - Country:US
Mailing Address - Phone:304-599-5000
Mailing Address - Fax:304-599-6629
Practice Address - Street 1:3000 HAMPTON CTR
Practice Address - Street 2:SUITE B
Practice Address - City:MORGANTOWN
Practice Address - State:WV
Practice Address - Zip Code:26505-1708
Practice Address - Country:US
Practice Address - Phone:304-599-5000
Practice Address - Fax:304-599-6629
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-01-04
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV21161223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV01525386OtherUNITED CONCORDIA ID
WV0138658000Medicaid