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General NPI Number Information
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NPI Number | 1982807285
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Entity Type | Organization
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Legal Business Name | NORMAN PRILLAMAN DDS LTD
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Dates
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Enumeration Date | 06/06/2007
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Last Update Date | 09/16/2008
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Provider Practice Location Address
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Address Line | 306 BROOK PARK PLACE
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City | FOREST
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State | VA
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Zip | 24551
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Country | US
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Telephone | 434-385-4499
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Fax | 434-385-7944
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Provider Business Mailing Address
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Address Line | 306 BROOK PARK PLACE
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City | FOREST
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State | VA
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Zip | 24551
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Country | US
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Telephone | 434-385-4499
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Fax | 434-385-7944
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Authorized Official
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Title or Position | OWNER/ORTHODONTIST
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Name | WILLIAM NORMAN PRILLAMAN II
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Credential | DDS
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Telephone | 434-385-4499
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number | 0401008100
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License Number State | VA
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