MEDICARE: NORMAN D. KNOWLES, D.M.D., P.A.

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

General Provider Information

NPI Number	:	1952753154
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NORMAN D. KNOWLES, D.M.D., P.A.

Provider Business Mailing Address
First Line	:	3760 20TH ST
Second Line	:	SUITE A
City	:	VERO BEACH
State	:	FL
Zip	:	32960-2464
Country	:	US
Telephone Number	:	772-778-0954
Fax Number	:	772-778-0955

Provider Business Practice Location Address
First Line	:	3760 20TH ST
Second Line	:	SUITE A
City	:	VERO BEACH
State	:	FL
Zip	:	32960-2464
Country	:	US
Telephone Number	:	772-778-0954
Fax Number	:	772-778-0955

Authorized Official
Title or Position	:	OWNER
Name	:	NORMAN D. KNOWLES
Credential	:	D.M.D.
Telephone Number	:	772-778-0954

Provider Enumeration Date	:	07/12/2016
Last Update Date	:	07/12/2016

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