Provider Demographics
NPI:1801095070
Name:ORFUS, MANDY ROBIN (DDS MS)
Entity type:Individual
Prefix:DR
First Name:MANDY
Middle Name:ROBIN
Last Name:ORFUS
Suffix:
Gender:F
Credentials:DDS MS
Other - Prefix:DR
Other - First Name:MANDY
Other - Middle Name:ROBIN
Other - Last Name:WILKINSON
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DDS MS
Mailing Address - Street 1:12320 BARKER CYPRESS RD
Mailing Address - Street 2:SUITE 700
Mailing Address - City:CYPRESS
Mailing Address - State:TX
Mailing Address - Zip Code:77429-8325
Mailing Address - Country:US
Mailing Address - Phone:281-225-6784
Mailing Address - Fax:
Practice Address - Street 1:303 HUNTERS TRAIL ST
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77024-6901
Practice Address - Country:US
Practice Address - Phone:713-468-7823
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-17
Last Update Date:2007-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX191781223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics