Provider Demographics
NPI:1205925526
Name:OLDROYD, ROGER DAVID (DDS)
Entity type:Individual
Prefix:DR
First Name:ROGER
Middle Name:DAVID
Last Name:OLDROYD
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 1:2532 E 7TH AVE
Mailing Address - Street 2:
Mailing Address - City:FLAGSTAFF
Mailing Address - State:AZ
Mailing Address - Zip Code:86004-3719
Mailing Address - Country:US
Mailing Address - Phone:928-779-5183
Mailing Address - Fax:928-526-4918
Practice Address - Street 1:2532 E 7TH AVE
Practice Address - Street 2:
Practice Address - City:FLAGSTAFF
Practice Address - State:AZ
Practice Address - Zip Code:86004-3719
Practice Address - Country:US
Practice Address - Phone:928-779-5183
Practice Address - Fax:928-526-4918
Is Sole Proprietor?:No
Enumeration Date:2006-10-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ5840122300000X, 1223P0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered122300000XDental ProvidersDentist
Not Answered1223P0700XDental ProvidersDentistProsthodontics