Provider Demographics
NPI:1295829158
Name:ORMSBY, JOHN DOUGLAS (DMD)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:DOUGLAS
Last Name:ORMSBY
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:J
Other - Middle Name:DOUGLAS
Other - Last Name:ORMSBY
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DMD
Mailing Address - Street 1:4752 SR 655
Mailing Address - Street 2:SUITE C
Mailing Address - City:BELLEVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:17004
Mailing Address - Country:US
Mailing Address - Phone:717-935-2295
Mailing Address - Fax:717-935-5095
Practice Address - Street 1:4752 SR 655
Practice Address - Street 2:SUITE C
Practice Address - City:BELLEVILLE
Practice Address - State:PA
Practice Address - Zip Code:17004
Practice Address - Country:US
Practice Address - Phone:717-935-2295
Practice Address - Fax:717-935-5095
Is Sole Proprietor?:No
Enumeration Date:2006-10-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS025768L122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA434076OtherUNITED CONCORDIA