Provider Demographics
NPI:1538552906
Name:NORMAN, PAULA MICHELLE (PHDHP)
Entity type:Individual
Prefix:
First Name:PAULA
Middle Name:MICHELLE
Last Name:NORMAN
Suffix:
Gender:F
Credentials:PHDHP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2 ROCKY BEND RD
Mailing Address - Street 2:
Mailing Address - City:CLEARFIELD
Mailing Address - State:PA
Mailing Address - Zip Code:16830-1002
Mailing Address - Country:US
Mailing Address - Phone:814-765-1905
Mailing Address - Fax:
Practice Address - Street 1:2 ROCKY BEND RD
Practice Address - Street 2:
Practice Address - City:CLEARFIELD
Practice Address - State:PA
Practice Address - Zip Code:16830-1002
Practice Address - Country:US
Practice Address - Phone:814-765-1905
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-03-10
Last Update Date:2015-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPHDH000076124Q00000X
PADH011129L124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist