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General NPI Number Information
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NPI Number | 1043859119
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Entity Type | Organization
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Legal Business Name | ORTHOROKS, LLC
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Dates
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Enumeration Date | 01/06/2020
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Last Update Date | 01/06/2020
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Provider Practice Location Address
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Address Line | 100 SHAWAN RD STE E
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City | HUNT VALLEY
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State | MD
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Zip | 21030-1459
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Country | US
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Telephone | 888-885-7657
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Fax |
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Provider Business Mailing Address
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Address Line | 100 SHAWAN RD STE E
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City | HUNT VALLEY
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State | MD
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Zip | 21030-1459
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Country | US
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Telephone | 888-885-7657
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Fax | 210-625-7398
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Authorized Official
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Title or Position | CEO/DENTIST
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Name | DR. RICHA DUTTA
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Credential | MD
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Telephone | 888-885-7657
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number |
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License Number State |
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