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General NPI Number Information
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NPI Number | 1932451341
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Entity Type | Organization
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Legal Business Name | NORMAN B. FINE, D.M.D., P.C.
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Dates
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Enumeration Date | 10/09/2012
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Last Update Date | 10/09/2012
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Provider Practice Location Address
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Address Line | 517 W BUTLER RD
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City | GREENVILLE
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State | SC
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Zip | 29607-4833
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Country | US
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Telephone | 864-299-5900
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Fax | 864-299-5033
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Provider Business Mailing Address
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Address Line | 517 W BUTLER RD
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City | GREENVILLE
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State | SC
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Zip | 29607-4833
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Country | US
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Telephone | 864-299-5900
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Fax | 864-299-5033
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Authorized Official
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Title or Position | OFFICE ADMINISTRATOR
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Name | BRANDY L MERRITT
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Credential |
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Telephone | 864-299-5900
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223P0300X
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Taxonomy Name | Periodontics
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License Number | 4480-762
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License Number State | SC
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