Provider Demographics
NPI:1841478310
Name:ORR, RICHARD A (DDS)
Entity type:Individual
Prefix:
First Name:RICHARD
Middle Name:A
Last Name:ORR
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 1:39 NORTH SAN MATEO DRIVE
Mailing Address - Street 2:SUITE #2
Mailing Address - City:SAN MATEO
Mailing Address - State:CA
Mailing Address - Zip Code:94401
Mailing Address - Country:US
Mailing Address - Phone:650-342-8044
Mailing Address - Fax:650-342-8077
Practice Address - Street 1:39 NORTH SAN MATEO DRIVE
Practice Address - Street 2:SUITE 2
Practice Address - City:SAN MATEO
Practice Address - State:CA
Practice Address - Zip Code:94401
Practice Address - Country:US
Practice Address - Phone:650-342-8044
Practice Address - Fax:650-342-8077
Is Sole Proprietor?:No
Enumeration Date:2008-02-06
Last Update Date:2008-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA22656122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist