Healthcare Provider Details

I. General information

NPI: 1679687867
Provider Name (Legal Business Name): SCOTT ALAN NORTON DMD MSD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/18/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4010 DUPONT CIRCLE STE 276
LOUISVILLE KY
40207
US

IV. Provider business mailing address

4010 DUPONT CIRCLE STE 276
LOUISVILLE KY
40207
US

V. Phone/Fax

Practice location:
  • Phone: 502-899-5559
  • Fax: 502-899-5508
Mailing address:
  • Phone: 502-899-5559
  • Fax: 502-899-5508

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223E0200X
TaxonomyEndodontics
License NumberKY7111
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: