Provider Demographics
NPI:1174678585
Name:ORR, MARK FRANK (DDS, MD)
Entity type:Individual
Prefix:DR
First Name:MARK
Middle Name:FRANK
Last Name:ORR
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Gender:M
Credentials:DDS, MD
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Mailing Address - Street 1:2014 CARIBOU DR
Mailing Address - Street 2:SUITE 100
Mailing Address - City:FORT COLLINS
Mailing Address - State:CO
Mailing Address - Zip Code:80525-4335
Mailing Address - Country:US
Mailing Address - Phone:970-225-9555
Mailing Address - Fax:970-223-2294
Practice Address - Street 1:2014 CARIBOU DR
Practice Address - Street 2:SUITE 100
Practice Address - City:FORT COLLINS
Practice Address - State:CO
Practice Address - Zip Code:80525-4335
Practice Address - Country:US
Practice Address - Phone:970-225-9555
Practice Address - Fax:970-223-2294
Is Sole Proprietor?:No
Enumeration Date:2007-01-24
Last Update Date:2022-09-15
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Provider Licenses
StateLicense IDTaxonomies
CO84331223S0112X
CO41928204E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes204E00000XAllopathic & Osteopathic PhysiciansOral & Maxillofacial Surgery
No1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO69228817Medicaid