Provider Demographics
NPI:1740567817
Name:ORTHOPROS PLLC
Entity Type:Organization
Organization Name:ORTHOPROS PLLC
Other - Org Name:1223X0400X
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:ROSIE
Authorized Official - Middle Name:P
Authorized Official - Last Name:CORRALES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:520-290-8787
Mailing Address - Street 1:150 N PANTANO RD STE 100
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85710-2300
Mailing Address - Country:US
Mailing Address - Phone:520-290-8787
Mailing Address - Fax:520-290-2278
Practice Address - Street 1:150 N PANTANO RD STE 100
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85710-2300
Practice Address - Country:US
Practice Address - Phone:520-290-8787
Practice Address - Fax:520-290-2278
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-11-03
Last Update Date:2011-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Single Specialty