Healthcare Provider Details

I. General information

NPI: 1659359339
Provider Name (Legal Business Name): ROY E DAY D.D.S.
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 01/04/2006
Last Update Date: 07/09/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3000 HAMPTON CTR SUITE B
MORGANTOWN WV
26505-1708
US

IV. Provider business mailing address

3000 HAMPTON CTR SUITE B
MORGANTOWN WV
26505-1708
US

V. Phone/Fax

Practice location:
  • Phone: 304-599-5000
  • Fax: 304-599-6629
Mailing address:
  • Phone: 304-599-5000
  • Fax: 304-599-6629

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223P0221X
TaxonomyPediatric Dentistry
License Number2116
License Number StateWV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: