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General NPI Number Information
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NPI Number | 1376932459
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Entity Type | Organization
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Legal Business Name | EUGENE ROYTMAN DMD, INC
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Dates
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Enumeration Date | 01/13/2015
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Last Update Date | 01/14/2015
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Provider Practice Location Address
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Address Line | 1866 B STREET
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City | HAYWARD
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State | CA
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Zip | 94541
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Country | US
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Telephone | 415-584-8500
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Fax | 415-584-8554
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Provider Business Mailing Address
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Address Line | 1866 B ST
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City | HAYWARD
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State | CA
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Zip | 94541-3139
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Country | US
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Telephone | 415-584-8500
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Fax | 415-584-8554
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Authorized Official
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Title or Position | OWNER
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Name | DR. EUGENE ROYTMAN
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Credential | DMD
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Telephone | 415-584-8500
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 46523
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License Number State | CA
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