Provider Demographics
NPI:1730308222
Name:ORR, ROBERT L (DDS,MSD)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:L
Last Name:ORR
Suffix:
Gender:M
Credentials:DDS,MSD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:500 PATTERSON RD
Mailing Address - Street 2:
Mailing Address - City:GRAND JUNCTION
Mailing Address - State:CO
Mailing Address - Zip Code:81506-1962
Mailing Address - Country:US
Mailing Address - Phone:970-243-1532
Mailing Address - Fax:970-243-1541
Practice Address - Street 1:500 PATTERSON RD
Practice Address - Street 2:
Practice Address - City:GRAND JUNCTION
Practice Address - State:CO
Practice Address - Zip Code:81506-1962
Practice Address - Country:US
Practice Address - Phone:970-243-1532
Practice Address - Fax:970-243-1541
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO29971223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics