Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 1223S0112X | Oral and Maxillofacial Surgeon | 8433 | CO |
N | 204E00000X | Oral & Maxillofacial Surgeon | 41928 | CO |
NPI | 1174678585 |
---|---|
Provider Name | Dr. Mark Frank Orr |
First Address | Fort Collins, CO 80525-4335 |
Second Address | Fort Collins, CO 80525-4335 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/01/2007 |
Last Update Date | 09/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
69228817 | (05) | CO |