Provider Demographics
NPI:1336533074
Name:ROY, BETH A (DENTAL HYGIENIST)
Entity type:Individual
Prefix:
First Name:BETH
Middle Name:A
Last Name:ROY
Suffix:
Gender:F
Credentials:DENTAL HYGIENIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:468 W MAIN ST
Mailing Address - Street 2:P.O. BOX 308
Mailing Address - City:TILTON
Mailing Address - State:NH
Mailing Address - Zip Code:03276-5020
Mailing Address - Country:US
Mailing Address - Phone:603-286-8618
Mailing Address - Fax:
Practice Address - Street 1:468 W MAIN ST
Practice Address - Street 2:
Practice Address - City:TILTON
Practice Address - State:NH
Practice Address - Zip Code:03276-5020
Practice Address - Country:US
Practice Address - Phone:603-286-8618
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-03-19
Last Update Date:2015-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH01659124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist