MEDICARE: DR. ROY DELAPPE D.D.S.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry	4833T	NV

General Provider Information

NPI Number	:	1104927383
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ROY DELAPPE D.D.S.

Provider Business Mailing Address
First Line	:	1101 W MOANA LN
Second Line	:	SUITE #4
City	:	RENO
State	:	NV
Zip	:	89509-4775
Country	:	US
Telephone Number	:	775-412-1070
Fax Number	:

Provider Business Practice Location Address
First Line	:	1101 W MOANA LN
Second Line	:	SUITE #4
City	:	RENO
State	:	NV
Zip	:	89509-4775
Country	:	US
Telephone Number	:	775-412-1070
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/26/2006
Last Update Date	:	03/24/2011

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