MEDICARE: DR. NORMAN DAVID KNOWLES DMD

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	1223G0001X	General Practice Dentistry	DN 0012337	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	DN12337	OTHER	FL	STATE LICENSE
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1588766513
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. NORMAN DAVID KNOWLES DMD

Provider Business Mailing Address
First Line	:	1511 S 25TH ST STE B
Second Line	:
City	:	FORT PIERCE
State	:	FL
Zip	:	34947-4779
Country	:	US
Telephone Number	:	772-464-7214
Fax Number	:	772-464-9946

Provider Business Practice Location Address
First Line	:	1511 S 25TH ST STE B
Second Line	:
City	:	FORT PIERCE
State	:	FL
Zip	:	34947-4779
Country	:	US
Telephone Number	:	772-464-7214
Fax Number	:	772-464-9946

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

Provider Enumeration Date	:	09/01/2006
Last Update Date	:	02/23/2017

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