Provider Demographics
NPI:1326434267
Name:HARLEY S. ORZAME,DMD,INC.
Entity Type:Organization
Organization Name:HARLEY S. ORZAME,DMD,INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:HARLEY
Authorized Official - Middle Name:SAGUN
Authorized Official - Last Name:ORZAME
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:626-917-1267
Mailing Address - Street 1:1365 N HACIENDA BLVD
Mailing Address - Street 2:
Mailing Address - City:LA PUENTE
Mailing Address - State:CA
Mailing Address - Zip Code:91744-1600
Mailing Address - Country:US
Mailing Address - Phone:626-917-1267
Mailing Address - Fax:626-918-9647
Practice Address - Street 1:1365 N HACIENDA BLVD
Practice Address - Street 2:
Practice Address - City:LA PUENTE
Practice Address - State:CA
Practice Address - Zip Code:91744-1600
Practice Address - Country:US
Practice Address - Phone:626-917-1267
Practice Address - Fax:626-918-9647
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-04-07
Last Update Date:2015-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAB319671223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty