MEDICARE: DR. VINNA C NORRIS D.D.S.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	122300000X	Dentist	9953	CO

General Provider Information

NPI Number	:	1508094624
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. VINNA C NORRIS D.D.S.

Provider Business Mailing Address
First Line	:	1221 E ELIZABETH ST STE 2
Second Line	:
City	:	FORT COLLINS
State	:	CO
Zip	:	80524-4066
Country	:	US
Telephone Number	:	970-221-1400
Fax Number	:	970-416-7778

Provider Business Practice Location Address
First Line	:	1221 E ELIZABETH ST STE 2
Second Line	:
City	:	FORT COLLINS
State	:	CO
Zip	:	80524-4066
Country	:	US
Telephone Number	:	970-221-1400
Fax Number	:	970-416-7778

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/26/2009
Last Update Date	:	01/27/2017

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