Provider Demographics
NPI:1104563402
Name:ORR, STEPHEN (DMD)
Entity type:Individual
Prefix:DR
First Name:STEPHEN
Middle Name:
Last Name:ORR
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1710 HIGHWAY 121 BYP N STE B
Mailing Address - Street 2:
Mailing Address - City:MURRAY
Mailing Address - State:KY
Mailing Address - Zip Code:42071-8912
Mailing Address - Country:US
Mailing Address - Phone:270-753-1000
Mailing Address - Fax:
Practice Address - Street 1:1710 HIGHWAY 121 BYP N STE B
Practice Address - Street 2:
Practice Address - City:MURRAY
Practice Address - State:KY
Practice Address - Zip Code:42071-8912
Practice Address - Country:US
Practice Address - Phone:270-753-1000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-05-18
Last Update Date:2022-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY107611223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice