Provider Demographics
NPI:1750457818
Name:DRS. ORTIZ AND HEAL-ORTIZ, INC.
Entity Type:Organization
Organization Name:DRS. ORTIZ AND HEAL-ORTIZ, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MARK
Authorized Official - Middle Name:GREGORY
Authorized Official - Last Name:ORTIZ
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:304-622-9837
Mailing Address - Street 1:432 W MAIN ST
Mailing Address - Street 2:
Mailing Address - City:CLARKSBURG
Mailing Address - State:WV
Mailing Address - Zip Code:26301-2817
Mailing Address - Country:US
Mailing Address - Phone:304-622-9837
Mailing Address - Fax:304-623-1754
Practice Address - Street 1:432 W MAIN ST
Practice Address - Street 2:
Practice Address - City:CLARKSBURG
Practice Address - State:WV
Practice Address - Zip Code:26301-2817
Practice Address - Country:US
Practice Address - Phone:304-622-9837
Practice Address - Fax:304-623-1754
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-28
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty