Provider Demographics
NPI:1104029073
Name:ANDRONIC, NORMA L (DDS)
Entity type:Individual
Prefix:DR
First Name:NORMA
Middle Name:L
Last Name:ANDRONIC
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2744 CAPE DR
Mailing Address - Street 2:
Mailing Address - City:CORONA
Mailing Address - State:CA
Mailing Address - Zip Code:92882-5764
Mailing Address - Country:US
Mailing Address - Phone:619-729-9834
Mailing Address - Fax:
Practice Address - Street 1:6445 PATS RANCH RD STE G
Practice Address - Street 2:
Practice Address - City:JURUPA VALLEY
Practice Address - State:CA
Practice Address - Zip Code:91752-4439
Practice Address - Country:US
Practice Address - Phone:951-808-5881
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-07
Last Update Date:2024-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA538971223G0001X, 122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
No1223G0001XDental ProvidersDentistGeneral Practice