Provider Demographics
NPI:1083874960
Name:ORR, ANNE MARY (DDS)
Entity Type:Individual
Prefix:DR
First Name:ANNE
Middle Name:MARY
Last Name:ORR
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1509 S PARK DR
Mailing Address - Street 2:
Mailing Address - City:BROKEN BOW
Mailing Address - State:OK
Mailing Address - Zip Code:74728-5722
Mailing Address - Country:US
Mailing Address - Phone:580-584-3403
Mailing Address - Fax:580-584-3423
Practice Address - Street 1:1509 S PARK DR
Practice Address - Street 2:
Practice Address - City:BROKEN BOW
Practice Address - State:OK
Practice Address - Zip Code:74728-5722
Practice Address - Country:US
Practice Address - Phone:580-584-3403
Practice Address - Fax:580-584-3423
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-13
Last Update Date:2008-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK5140122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist