MEDICARE: DR. DANIEL L ORR II DDS, PHD, JD, MD

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	1223S0112X	Oral and Maxillofacial Surgery (Dentist)	S2-12	NV
2	209800000X	Legal Medicine (M.D./D.O.) Physician	S2-12	NV
3	1223D0004X	Dental Anesthesiology	S2-12	NV

General Provider Information

NPI Number	:	1134265507
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DANIEL L ORR II DDS, PHD, JD, MD

Provider Business Mailing Address
First Line	:	2040 W. CHARLESTON BLVD.
Second Line	:	SUITE 201
City	:	LAS VEGAS
State	:	NV
Zip	:	89102-2287
Country	:	US
Telephone Number	:	702-383-3711
Fax Number	:	702-383-2653

Provider Business Practice Location Address
First Line	:	2040 W. CHARLESTON BLVD.
Second Line	:	SUITE 201
City	:	LAS VEGAS
State	:	NV
Zip	:	89102-2287
Country	:	US
Telephone Number	:	702-383-3711
Fax Number	:	702-383-2653

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

Provider Enumeration Date	:	01/30/2007
Last Update Date	:	05/17/2013

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