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General NPI Number Information
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NPI Number | 1225109887
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Entity Type | Organization
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Legal Business Name | NORFOLK DENTAL GROUP LLP
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Dates
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Enumeration Date | 11/13/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1502 N 13TH ST
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City | NORFOLK
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State | NE
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Zip | 68701-2381
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Country | US
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Telephone | 402-371-1360
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Fax | 402-371-1278
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Provider Business Mailing Address
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Address Line | PO BOX 1203
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City | NORFOLK
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State | NE
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Zip | 68702-1203
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Country | US
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Telephone | 402-371-1360
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Fax | 402-371-1278
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. DAVID MERRITT
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Credential | DDS
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Telephone | 402-371-1360
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number |
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License Number State |
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