Provider Demographics
NPI:1104152529
Name:ORZA, EMIL (DDS)
Entity type:Individual
Prefix:DR
First Name:EMIL
Middle Name:
Last Name:ORZA
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5600 BRIGHTON ROSE LN
Mailing Address - Street 2:
Mailing Address - City:SUGAR HILL
Mailing Address - State:GA
Mailing Address - Zip Code:30518-7706
Mailing Address - Country:US
Mailing Address - Phone:770-641-9261
Mailing Address - Fax:
Practice Address - Street 1:1699 DULUTH HWY
Practice Address - Street 2:
Practice Address - City:LAWRENCEVILLE
Practice Address - State:GA
Practice Address - Zip Code:30043-5010
Practice Address - Country:US
Practice Address - Phone:770-338-1963
Practice Address - Fax:770-338-8626
Is Sole Proprietor?:Yes
Enumeration Date:2009-10-19
Last Update Date:2009-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GADN0139761223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice