Provider Demographics
NPI:1245290220
Name:ROYAL, DENNIS RAY (DC)
Entity type:Individual
Prefix:DR
First Name:DENNIS
Middle Name:RAY
Last Name:ROYAL
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:532A N MCPHERSON CHURCH RD
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28303-4497
Mailing Address - Country:US
Mailing Address - Phone:910-860-3050
Mailing Address - Fax:910-860-3080
Practice Address - Street 1:532A N MCPHERSON CHURCH RD
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28303-4497
Practice Address - Country:US
Practice Address - Phone:910-860-3050
Practice Address - Fax:910-860-3080
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-24
Last Update Date:2011-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC2628111N00000X
NC3100111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC89085JXMedicaid
NC085JXOtherBLUE CROSS BLUE SHIELD
NC2212152OtherFIRST HEALTH
NC647611OtherUNITED HEALTH CARE
NC2212152OtherFIRST HEALTH
NC647611OtherUNITED HEALTH CARE