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General NPI Number Information
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NPI Number | 1548431455
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Entity Type | Organization
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Legal Business Name | DR. HEATHER D. RORISON
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Dates
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Enumeration Date | 03/19/2008
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Last Update Date | 06/12/2008
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Provider Practice Location Address
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Address Line | 4400 COLWICK RD
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City | CHARLOTTE
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State | NC
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Zip | 28211-2312
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Country | US
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Telephone | 704-366-6186
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Fax | 704-366-3792
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Provider Business Mailing Address
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Address Line | 4400 COLWICK RD
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City | CHARLOTTE
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State | NC
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Zip | 28211-2312
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Country | US
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Telephone | 704-366-6186
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Fax | 704-366-3792
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Authorized Official
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Title or Position | DOCTOR
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Name | DR. HEATHER D RORISON
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Credential | DMD
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Telephone | 704-366-6186
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 7802
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License Number State | NC
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