Provider Demographics
NPI:1336322395
Name:OROZCO, ABBEY SULLIVAN (DMD)
Entity Type:Individual
Prefix:DR
First Name:ABBEY
Middle Name:SULLIVAN
Last Name:OROZCO
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:357 S GULPH RD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:KING OF PRUSSIA
Mailing Address - State:PA
Mailing Address - Zip Code:19406-3136
Mailing Address - Country:US
Mailing Address - Phone:610-337-2325
Mailing Address - Fax:
Practice Address - Street 1:357 S GULPH RD
Practice Address - Street 2:SUITE 100
Practice Address - City:KING OF PRUSSIA
Practice Address - State:PA
Practice Address - Zip Code:19406-3136
Practice Address - Country:US
Practice Address - Phone:610-337-2325
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-12-13
Last Update Date:2015-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS037208122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1336322395Medicaid