Provider Demographics
NPI:1831252261
Name:ORCHER, JON STANLEY (DDS DOCTOR OF DENTAL)
Entity type:Individual
Prefix:
First Name:JON
Middle Name:STANLEY
Last Name:ORCHER
Suffix:
Gender:M
Credentials:DDS DOCTOR OF DENTAL
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16141 BOLSA CHICA ROAD
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92649
Mailing Address - Country:US
Mailing Address - Phone:714-846-2839
Mailing Address - Fax:714-840-0477
Practice Address - Street 1:16141 BOLSA CHICA ROAD
Practice Address - Street 2:
Practice Address - City:HUNTINGTON BEACH
Practice Address - State:CA
Practice Address - Zip Code:92649
Practice Address - Country:US
Practice Address - Phone:714-846-2839
Practice Address - Fax:714-840-0477
Is Sole Proprietor?:No
Enumeration Date:2006-12-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA465101223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice