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General NPI Number Information
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NPI Number | 1326434267
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Entity Type | Organization
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Legal Business Name | HARLEY S. ORZAME,DMD,INC.
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Dates
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Enumeration Date | 04/07/2015
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Last Update Date | 04/07/2015
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Provider Practice Location Address
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Address Line | 1365 N HACIENDA BLVD
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City | LA PUENTE
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State | CA
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Zip | 91744-1600
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Country | US
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Telephone | 626-917-1267
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Fax | 626-918-9647
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Provider Business Mailing Address
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Address Line | 1365 N HACIENDA BLVD
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City | LA PUENTE
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State | CA
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Zip | 91744-1600
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Country | US
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Telephone | 626-917-1267
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Fax | 626-918-9647
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. HARLEY SAGUN ORZAME
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Credential | DMD
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Telephone | 626-917-1267
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | B31967
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License Number State | CA
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