Provider Demographics
NPI:1831249648
Name:ROYAL, JOHN E (DDS)
Entity type:Individual
Prefix:DR
First Name:JOHN
Middle Name:E
Last Name:ROYAL
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
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Mailing Address - Street 1:97 BEECHLAND ROAD
Mailing Address - Street 2:P.O. BOX 518
Mailing Address - City:ELLSWORTH
Mailing Address - State:ME
Mailing Address - Zip Code:04605
Mailing Address - Country:US
Mailing Address - Phone:207-667-0500
Mailing Address - Fax:207-667-7610
Practice Address - Street 1:97 BEECHLAND RD.
Practice Address - Street 2:BOX 518
Practice Address - City:ELLSWORTH
Practice Address - State:ME
Practice Address - Zip Code:04605
Practice Address - Country:US
Practice Address - Phone:207-667-0500
Practice Address - Fax:207-667-7610
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
ME26391223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery