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General NPI Number Information
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NPI Number | 1891812731
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Entity Type | Individual
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Provider Name | LEMONT TERRANCE NORRIS DDS
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Gender | Male
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Dates
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Enumeration Date | 03/24/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 1713 CLAY ST STE 5
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City | VICKSBURG
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State | MS
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Zip | 39183-3048
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Country | US
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Telephone | 601-638-7007
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Fax | 601-638-0760
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Provider Business Mailing Address
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Address Line | 1713 CLAY ST STE 5
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City | VICKSBURG
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State | MS
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Zip | 39183-3048
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Country | US
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Telephone | 601-638-7007
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Fax | 601-638-0760
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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 | 2864-95
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License Number State | MS
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