Provider Demographics
NPI:1750826111
Name:ORION OAKS DENTAL
Entity Type:Organization
Organization Name:ORION OAKS DENTAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:EDWARD
Authorized Official - Last Name:WHITE
Authorized Official - Suffix:III
Authorized Official - Credentials:DDS
Authorized Official - Phone:248-693-4422
Mailing Address - Street 1:400 W CLARKSTON RD
Mailing Address - Street 2:SUITE A
Mailing Address - City:LAKE ORION
Mailing Address - State:MI
Mailing Address - Zip Code:48362-4101
Mailing Address - Country:US
Mailing Address - Phone:248-693-4422
Mailing Address - Fax:248-693-6950
Practice Address - Street 1:400 W CLARKSTON RD
Practice Address - Street 2:
Practice Address - City:LAKE ORION
Practice Address - State:MI
Practice Address - Zip Code:48362-4101
Practice Address - Country:US
Practice Address - Phone:248-693-4422
Practice Address - Fax:248-693-6950
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-12-21
Last Update Date:2016-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty