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General NPI Number Information
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NPI Number | 1679942288
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Entity Type | Organization
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Legal Business Name | ORIS DENTAL OF ORANGE COUNTY PLLC
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Dates
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Enumeration Date | 09/24/2015
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Last Update Date | 09/24/2015
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Provider Practice Location Address
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Address Line | 61 ORANGE PLAZA LN
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City | MIDDLETOWN
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State | NY
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Zip | 10940-2254
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Country | US
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Telephone | 845-344-3844
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Fax | 845-344-4622
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Provider Business Mailing Address
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Address Line | 61 ORANGE PLAZA LN
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City | MIDDLETOWN
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State | NY
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Zip | 10940-2254
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Country | US
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Telephone | 845-344-3844
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Fax | 845-344-4622
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Authorized Official
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Title or Position | ENROLLMENT SPECIALIST
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Name | MS. JAMIE SOBON
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Credential |
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Telephone | 315-454-6000
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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 | 52828
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License Number State | NY
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