Healthcare Provider Details

I. General information

NPI: 1194013805
Provider Name (Legal Business Name): DARREN CARL NORBY DMD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/14/2011
Last Update Date: 07/14/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8400 OSUNA RD NE SUITE 1C
ALBUQUERQUE NM
87111-2087
US

IV. Provider business mailing address

8400 OSUNA RD NE SUITE 1C
ALBUQUERQUE NM
87111-2087
US

V. Phone/Fax

Practice location:
  • Phone: 505-296-1332
  • Fax:
Mailing address:
  • Phone: 505-296-1332
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223P0700X
TaxonomyProsthodontics
License NumberDD3543
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: