Provider Demographics
NPI:1043463342
Name:ORBACH, LISA (DDS)
Entity type:Individual
Prefix:
First Name:LISA
Middle Name:
Last Name:ORBACH
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10405 E. NORTHWEST HWY.
Mailing Address - Street 2:SUITE 306
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75238
Mailing Address - Country:US
Mailing Address - Phone:214-327-7359
Mailing Address - Fax:214-327-1951
Practice Address - Street 1:10405 E. NORTHWEST HWY.
Practice Address - Street 2:SUITE 306
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75238
Practice Address - Country:US
Practice Address - Phone:214-327-7359
Practice Address - Fax:214-327-1951
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-30
Last Update Date:2008-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX161571223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice