Basic Information
| Provider Information | |||||||||
| NPI: | 1104152529 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | ORZA | ||||||||
| FirstName: | EMIL | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | D.D.S. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 5600 BRIGHTON ROSE LN | ||||||||
| Address2: | |||||||||
| City: | SUGAR HILL | ||||||||
| State: | GA | ||||||||
| PostalCode: | 305187706 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7706419261 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 1699 DULUTH HWY | ||||||||
| Address2: | |||||||||
| City: | LAWRENCEVILLE | ||||||||
| State: | GA | ||||||||
| PostalCode: | 300435010 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7703381963 | ||||||||
| FaxNumber: | 7703388626 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/19/2009 | ||||||||
| LastUpdateDate: | 10/19/2009 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 1223G0001X | DN013976 | GA | Y | Dental Providers | Dentist | General Practice |
No ID Information.