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General NPI Number Information
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NPI Number | 1639543481
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Entity Type | Organization
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Legal Business Name | NORBO DENTAL, PLLC
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Dates
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Enumeration Date | 11/17/2015
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Last Update Date | 11/17/2015
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Provider Practice Location Address
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Address Line | 441 E MAIN ST
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City | PURCELLVILLE
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State | VA
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Zip | 20132-3170
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Country | US
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Telephone | 540-338-7325
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Fax | 540-338-9117
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Provider Business Mailing Address
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Address Line | PO BOX 300
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City | PURCELLVILLE
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State | VA
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Zip | 20134-0300
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Country | US
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Telephone | 540-338-7325
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Fax | 540-338-9117
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Authorized Official
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Title or Position | DENTIST/OWNER
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Name | DR. KIRK MYRON NORBO
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Credential | D.M.D.
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Telephone | 540-338-7325
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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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