Healthcare Provider Details

I. General information

NPI: 1225146640
Provider Name (Legal Business Name): MICHAEL KEVIN OROS DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/26/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

39 WEST MAIN STREET
AVON NY
14414
US

IV. Provider business mailing address

39 WEST MAIN STREET
AVON NY
14414
US

V. Phone/Fax

Practice location:
  • Phone: 585-226-2120
  • Fax:
Mailing address:
  • Phone: 585-226-2120
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License NumberLIC-50-040155
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: