Provider Demographics
NPI:1952636920
Name:ROYLE, BRIAN LAMAR (DDS)
Entity Type:Individual
Prefix:DR
First Name:BRIAN
Middle Name:LAMAR
Last Name:ROYLE
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 1:5094 N FRUIT AVE
Mailing Address - Street 2:SUITE 102
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93711-3061
Mailing Address - Country:US
Mailing Address - Phone:559-221-6200
Mailing Address - Fax:559-221-6206
Practice Address - Street 1:5094 N FRUIT AVE
Practice Address - Street 2:SUITE 102
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93711-3061
Practice Address - Country:US
Practice Address - Phone:559-221-6200
Practice Address - Fax:559-221-6206
Is Sole Proprietor?:No
Enumeration Date:2009-10-08
Last Update Date:2010-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA588341223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice