Provider Demographics
NPI:1548431455
Name:DR. HEATHER D. RORISON
Entity Type:Organization
Organization Name:DR. HEATHER D. RORISON
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:HEATHER
Authorized Official - Middle Name:D
Authorized Official - Last Name:RORISON
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:704-366-6186
Mailing Address - Street 1:4400 COLWICK RD
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28211-2312
Mailing Address - Country:US
Mailing Address - Phone:704-366-6186
Mailing Address - Fax:704-366-3792
Practice Address - Street 1:4400 COLWICK RD
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28211-2312
Practice Address - Country:US
Practice Address - Phone:704-366-6186
Practice Address - Fax:704-366-3792
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-19
Last Update Date:2008-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC7802122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty