Provider Demographics
NPI:1730242447
Name:NORRIS, TERRY L (DMD)
Entity type:Individual
Prefix:DR
First Name:TERRY
Middle Name:L
Last Name:NORRIS
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2200 EAST PARRISH AVENUE
Mailing Address - Street 2:BUILDING C - SUITE 201
Mailing Address - City:OWENSBORO
Mailing Address - State:KY
Mailing Address - Zip Code:42303-1451
Mailing Address - Country:US
Mailing Address - Phone:270-683-3269
Mailing Address - Fax:270-689-9107
Practice Address - Street 1:2200 EAST PARRISH AVENUE
Practice Address - Street 2:BUILDING C - SUITE 201
Practice Address - City:OWENSBORO
Practice Address - State:KY
Practice Address - Zip Code:42303-1451
Practice Address - Country:US
Practice Address - Phone:270-683-3269
Practice Address - Fax:270-689-9107
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY4875122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist