Provider Demographics
NPI:1225419930
Name:ORMAN, PATRICK WILLIAM IV (DMD)
Entity Type:Individual
Prefix:DR
First Name:PATRICK
Middle Name:WILLIAM
Last Name:ORMAN
Suffix:IV
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9 SURREY CT
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29212-3139
Mailing Address - Country:US
Mailing Address - Phone:803-772-5628
Mailing Address - Fax:
Practice Address - Street 1:7210 BROAD RIVER RD STE N
Practice Address - Street 2:
Practice Address - City:IRMO
Practice Address - State:SC
Practice Address - Zip Code:29063-8150
Practice Address - Country:US
Practice Address - Phone:803-407-2220
Practice Address - Fax:803-407-2320
Is Sole Proprietor?:No
Enumeration Date:2015-06-18
Last Update Date:2019-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC85591223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice