Provider Demographics
NPI:1356407894
Name:ORAZIO, THOMAS VINCENT (DMD)
Entity type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:VINCENT
Last Name:ORAZIO
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9370 SW GREENBURG RD STE 103
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97223-5428
Mailing Address - Country:US
Mailing Address - Phone:503-245-0082
Mailing Address - Fax:
Practice Address - Street 1:9370 SW GREENBURG RD STE 103
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97223-5428
Practice Address - Country:US
Practice Address - Phone:503-245-0082
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORD60991223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice