Healthcare Provider Details

I. General information

NPI: 1124109426
Provider Name (Legal Business Name): NORMAN W. GARN D.D.S.,M.S.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/17/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

676 N SAINT CLAIR ST #1750
CHICAGO IL
60611-2927
US

IV. Provider business mailing address

676 N SAINT CLAIR ST #1750
CHICAGO IL
60611-2927
US

V. Phone/Fax

Practice location:
  • Phone: 312-649-9214
  • Fax: 312-649-9560
Mailing address:
  • Phone: 312-649-9214
  • Fax: 312-649-9560

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223X0400X
TaxonomyOrthodontics and Dentofacial Orthopedics Dentistry
License Number
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: