Healthcare Provider Details

I. General information

NPI: 1174678585
Provider Name (Legal Business Name): MARK FRANK ORR D.D.S., M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/24/2007
Last Update Date: 09/15/2022
Certification Date: 09/15/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2014 CARIBOU DR SUITE 100
FORT COLLINS CO
80525-4335
US

IV. Provider business mailing address

2014 CARIBOU DR SUITE 100
FORT COLLINS CO
80525-4335
US

V. Phone/Fax

Practice location:
  • Phone: 970-225-9555
  • Fax: 970-223-2294
Mailing address:
  • Phone: 970-225-9555
  • Fax: 970-223-2294

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1223S0112X
TaxonomyOral and Maxillofacial Surgery (Dentist)
License Number8433
License Number StateCO
# 2
Primary TaxonomyY
Taxonomy Code204E00000X
TaxonomyOral & Maxillofacial Surgery (D.M.D.)
License Number41928
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: