Provider Demographics
NPI:1043859119
Name:ORTHOROKS, LLC
Entity Type:Organization
Organization Name:ORTHOROKS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:RICHA
Authorized Official - Middle Name:
Authorized Official - Last Name:DUTTA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:888-885-7657
Mailing Address - Street 1:100 SHAWAN RD STE E
Mailing Address - Street 2:
Mailing Address - City:HUNT VALLEY
Mailing Address - State:MD
Mailing Address - Zip Code:21030-1459
Mailing Address - Country:US
Mailing Address - Phone:888-885-7657
Mailing Address - Fax:210-625-7398
Practice Address - Street 1:100 SHAWAN RD STE E
Practice Address - Street 2:
Practice Address - City:HUNT VALLEY
Practice Address - State:MD
Practice Address - Zip Code:21030-1459
Practice Address - Country:US
Practice Address - Phone:888-885-7657
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-01-06
Last Update Date:2020-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Single Specialty