Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 122300000X | Dentist | 5840 | AZ |
N | 1223P0700X | Prosthodontist | 5840 | AZ |
NPI | 1205925526 |
---|---|
Provider Name | Dr. Roger David Oldroyd |
First Address | Flagstaff, AZ 86004-3719 |
Second Address | Flagstaff, AZ 86004-3719 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/10/2006 |
Last Update Date | 08/07/2007 |