MEDICARE: DR. LENORE KILLIAN-NORRIS D.M.D.

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	DI 17924	NJ

General Provider Information

NPI Number	:	1851412746
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. LENORE KILLIAN-NORRIS D.M.D.

Provider Business Mailing Address
First Line	:	5001 LINCOLN DR W
Second Line	:	SUITE B
City	:	MARLTON
State	:	NJ
Zip	:	08053-1522
Country	:	US
Telephone Number	:	856-596-5456
Fax Number	:	856-988-8512

Provider Business Practice Location Address
First Line	:	5001 LINCOLN DR W
Second Line	:	SUITE B
City	:	MARLTON
State	:	NJ
Zip	:	08053-1522
Country	:	US
Telephone Number	:	856-596-5456
Fax Number	:	856-988-8512

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

Provider Enumeration Date	:	04/02/2007
Last Update Date	:	07/08/2007

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