Healthcare Provider Details

I. General information

NPI: 1467535716
Provider Name (Legal Business Name): JAMES HAROLD ORR D.D.S.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/23/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3050 ROCKWOOD TRL
SAINT CHARLES MO
63303-6210
US

IV. Provider business mailing address

3050 ROCKWOOD TRL
SAINT CHARLES MO
63303-6210
US

V. Phone/Fax

Practice location:
  • Phone: 636-939-9088
  • Fax:
Mailing address:
  • Phone: 636-939-9088
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number10058
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: