Healthcare Provider Details
I. General information
NPI: 1639610041
Provider Name (Legal Business Name): JAMES R NORRIS DDS MS PC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 03/17/2017
Last Update Date: 03/17/2017
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1975 RESEARCH PKWY SUITE 305
COLORADO SPRINGS CO
80920-1025
US
IV. Provider business mailing address
1975 RESEARCH PKWY SUITE 305
COLORADO SPRINGS CO
80920-1025
US
V. Phone/Fax
- Phone: 719-599-7760
- Fax: 719-599-7490
- Phone: 719-599-7760
- Fax: 719-599-7490
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QD0000X |
| Taxonomy | Dental Clinic/Center |
| License Number | DEN 00007926 |
| License Number State | CO |
VIII. Authorized Official
Name: DR.
JAMES
ROBERT
NORRIS
Title or Position: PRESIDENT/OWNER
Credential: D.D.S., M.S.
Phone: 651-646-3252