Provider Demographics
NPI:1043221807
Name:ORME, DROSTAN N (DDS)
Entity Type:Individual
Prefix:
First Name:DROSTAN
Middle Name:N
Last Name:ORME
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:PO BOX 9
Mailing Address - Street 2:
Mailing Address - City:NAMPA
Mailing Address - State:ID
Mailing Address - Zip Code:83653-0009
Mailing Address - Country:US
Mailing Address - Phone:208-467-4431
Mailing Address - Fax:208-467-7684
Practice Address - Street 1:150 2ND ST
Practice Address - Street 2:BOX 218
Practice Address - City:MELBA
Practice Address - State:ID
Practice Address - Zip Code:83641-5199
Practice Address - Country:US
Practice Address - Phone:208-495-1011
Practice Address - Fax:208-495-1012
Is Sole Proprietor?:No
Enumeration Date:2006-08-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDD39861223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice