Provider Demographics
NPI:1447664818
Name:J A ROY DDS
Entity type:Organization
Organization Name:J A ROY DDS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:J
Authorized Official - Middle Name:A
Authorized Official - Last Name:ROY
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:304-824-7704
Mailing Address - Street 1:PO BOX 408
Mailing Address - Street 2:
Mailing Address - City:WEST HAMLIN
Mailing Address - State:WV
Mailing Address - Zip Code:25571
Mailing Address - Country:US
Mailing Address - Phone:304-824-7704
Mailing Address - Fax:304-824-7705
Practice Address - Street 1:29 LINCOLN PLAZA
Practice Address - Street 2:
Practice Address - City:WEST HAMLIN
Practice Address - State:WV
Practice Address - Zip Code:25571
Practice Address - Country:US
Practice Address - Phone:304-824-7704
Practice Address - Fax:304-824-7705
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-06-13
Last Update Date:2014-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WVD25771223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty