Provider Demographics
NPI:1306141304
Name:DANIEL P ROY
Entity type:Organization
Organization Name:DANIEL P ROY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:P
Authorized Official - Last Name:ROY
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:207-324-6281
Mailing Address - Street 1:1110 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:SANFORD
Mailing Address - State:ME
Mailing Address - Zip Code:04073-3612
Mailing Address - Country:US
Mailing Address - Phone:207-324-6281
Mailing Address - Fax:207-324-7143
Practice Address - Street 1:1110 MAIN ST
Practice Address - Street 2:
Practice Address - City:SANFORD
Practice Address - State:ME
Practice Address - Zip Code:04073-3612
Practice Address - Country:US
Practice Address - Phone:207-324-6281
Practice Address - Fax:207-324-7143
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-01-21
Last Update Date:2011-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty