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NPI Code Detail

MEDICARE: CLINTON J. NORRIS, D.D.S., P.C.

MEDICARE: CLINTON J. NORRIS, D.D.S., P.C.
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
1122300000XDentist0401007441VA

General Provider Information

NPI Number : 1962522839
Entity Type Code : Organization
Provider Name (Legal Business Name) : CLINTON J. NORRIS, D.D.S., P.C.
Provider Business Mailing Address
First Line : 4445 COX RD
Second Line :
City : GLEN ALLEN
State : VA
Zip : 23060-3326
Country : US
Telephone Number : 804-747-0044
Fax Number : 804-968-4871
Provider Business Practice Location Address
First Line : 4445 COX RD
Second Line :
City : GLEN ALLEN
State : VA
Zip : 23060-3326
Country : US
Telephone Number : 804-747-0044
Fax Number : 804-968-4871
Authorized Official
Title or Position : MANAGER
Name : DR. CLINTON JOSEPH NORRIS III
Credential : D.D.S.
Telephone Number : 804-747-0044
Provider Enumeration Date : 04/01/2007
Last Update Date : 12/27/2016

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