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General NPI Number Information
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NPI Number | 1902814551
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Entity Type | Individual
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Provider Name | KIMBERLY C. NORMAN D.D.S.
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Gender | Male
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Dates
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Enumeration Date | 08/03/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 734 W LAMAR ALEXANDER PKWY
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City | MARYVILLE
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State | TN
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Zip | 37801-3900
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Country | US
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Telephone | 865-982-9662
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Fax | 865-982-0147
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Provider Business Mailing Address
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Address Line | 1312 WATERSONG LN
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City | KNOXVILLE
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State | TN
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Zip | 37922-9324
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Country | US
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Telephone | 865-777-3689
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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 | 4322
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License Number State | TN
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