Provider Demographics
NPI:1265668917
Name:MCMILLIAN-ORR, ANGELA (DH)
Entity type:Individual
Prefix:
First Name:ANGELA
Middle Name:
Last Name:MCMILLIAN-ORR
Suffix:
Gender:F
Credentials:DH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8240 22ND AVE SE
Mailing Address - Street 2:
Mailing Address - City:OLYMPIA
Mailing Address - State:WA
Mailing Address - Zip Code:98513-3480
Mailing Address - Country:US
Mailing Address - Phone:360-200-6927
Mailing Address - Fax:
Practice Address - Street 1:8240 22ND AVE SE
Practice Address - Street 2:
Practice Address - City:OLYMPIA
Practice Address - State:WA
Practice Address - Zip Code:98513-3480
Practice Address - Country:US
Practice Address - Phone:360-200-6927
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-06-09
Last Update Date:2009-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GADH07371124Q00000X
CO905336124Q00000X
WAHL60097540124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist