Provider Demographics
NPI:1679678734
Name:ORSBORN, ALAN (DDS)
Entity Type:Individual
Prefix:DR
First Name:ALAN
Middle Name:
Last Name:ORSBORN
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21197 STATE ROUTE 410 E
Mailing Address - Street 2:
Mailing Address - City:BONNEY LAKE
Mailing Address - State:WA
Mailing Address - Zip Code:98391-8457
Mailing Address - Country:US
Mailing Address - Phone:253-862-0194
Mailing Address - Fax:253-862-9068
Practice Address - Street 1:21197 STATE ROUTE 410 E
Practice Address - Street 2:
Practice Address - City:BONNEY LAKE
Practice Address - State:WA
Practice Address - Zip Code:98391-8457
Practice Address - Country:US
Practice Address - Phone:253-862-0194
Practice Address - Fax:253-862-9068
Is Sole Proprietor?:No
Enumeration Date:2006-09-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA57471223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice