Provider Demographics
NPI:1346383817
Name:NORWOOD, HERMELINDA (DD,S)
Entity type:Individual
Prefix:MRS
First Name:HERMELINDA
Middle Name:
Last Name:NORWOOD
Suffix:
Gender:F
Credentials:DD,S
Other - Prefix:DR
Other - First Name:HERMELINDA
Other - Middle Name:
Other - Last Name:SAN MIGUEL
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DD,S,
Mailing Address - Street 1:3503 LAUREL BAY LOOP
Mailing Address - Street 2:
Mailing Address - City:ROUND ROCK
Mailing Address - State:TX
Mailing Address - Zip Code:78681-1120
Mailing Address - Country:US
Mailing Address - Phone:512-248-8249
Mailing Address - Fax:
Practice Address - Street 1:180 E WHITESTONE BLVD
Practice Address - Street 2:SUITE 162
Practice Address - City:CEDAR PARK
Practice Address - State:TX
Practice Address - Zip Code:78613-7433
Practice Address - Country:US
Practice Address - Phone:512-259-6633
Practice Address - Fax:512-259-6590
Is Sole Proprietor?:No
Enumeration Date:2007-02-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX198261223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice