MEDICARE: DR. DARYL JON ROY DMD

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	1223P0700X	Prosthodontics	DN10613	FL

General Provider Information

NPI Number	:	1003823394
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DARYL JON ROY DMD

Provider Business Mailing Address
First Line	:	4431 NE 19TH AVE
Second Line	:
City	:	OAKLAND PARK
State	:	FL
Zip	:	33308-5105
Country	:	US
Telephone Number	:	954-557-7440
Fax Number	:

Provider Business Practice Location Address
First Line	:	4431 NE 19TH AVE
Second Line	:
City	:	OAKLAND PARK
State	:	FL
Zip	:	33308-5105
Country	:	US
Telephone Number	:	954-557-7440
Fax Number	:

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

Provider Enumeration Date	:	08/01/2006
Last Update Date	:	03/03/2013

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