Provider Demographics
NPI:1902592579
Name:ORR, CAYLOR MARK (DMD)
Entity type:Individual
Prefix:
First Name:CAYLOR
Middle Name:MARK
Last Name:ORR
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2704 N OAK ST BLDG C1
Mailing Address - Street 2:
Mailing Address - City:VALDOSTA
Mailing Address - State:GA
Mailing Address - Zip Code:31602-1796
Mailing Address - Country:US
Mailing Address - Phone:229-392-6540
Mailing Address - Fax:
Practice Address - Street 1:802 CENTRAL AVE N
Practice Address - Street 2:
Practice Address - City:TIFTON
Practice Address - State:GA
Practice Address - Zip Code:31794-3966
Practice Address - Country:US
Practice Address - Phone:229-586-6030
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-04-17
Last Update Date:2025-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GADN1230911223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice