Provider Demographics
NPI:1992927800
Name:ORIMO, LOUIS MICHAEL (DDS)
Entity type:Individual
Prefix:
First Name:LOUIS
Middle Name:MICHAEL
Last Name:ORIMO
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 1:2389 W. MARCH LANE
Mailing Address - Street 2:SUITE 1
Mailing Address - City:STOCKTON
Mailing Address - State:CA
Mailing Address - Zip Code:95207-5247
Mailing Address - Country:US
Mailing Address - Phone:209-477-0278
Mailing Address - Fax:209-951-0350
Practice Address - Street 1:2389 W. MARCH LANE
Practice Address - Street 2:SUITE 1
Practice Address - City:STOCKTON
Practice Address - State:CA
Practice Address - Zip Code:95207-5247
Practice Address - Country:US
Practice Address - Phone:209-477-0278
Practice Address - Fax:209-951-0350
Is Sole Proprietor?:No
Enumeration Date:2007-05-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC0338261223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice