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General NPI Number Information
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NPI Number | 1801278973
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Entity Type | Individual
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Provider Name | JERRICA NORVELL D.M.D.
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Gender | Female
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Dates
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Enumeration Date | 06/24/2015
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Last Update Date | 06/24/2015
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Provider Practice Location Address
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Address Line | 821 S HIGHWAY 25 W
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City | WILLIAMSBURG
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State | KY
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Zip | 40769-1918
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Country | US
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Telephone | 606-549-0374
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Fax |
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Provider Business Mailing Address
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Address Line | 1408 BRYANT RIDGE RD
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City | LIBERTY
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State | KY
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Zip | 42539-7063
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Country | US
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Telephone | 606-706-0408
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 9607
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License Number State | KY
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