Provider Demographics
NPI:1467294504
Name:NORRIS, ANNA CAROLINE (DMD)
Entity type:Individual
Prefix:
First Name:ANNA
Middle Name:CAROLINE
Last Name:NORRIS
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:700 DANIEL ELLIS DR APT 10105
Mailing Address - Street 2:
Mailing Address - City:CHARLESTON
Mailing Address - State:SC
Mailing Address - Zip Code:29412-3069
Mailing Address - Country:US
Mailing Address - Phone:334-224-5365
Mailing Address - Fax:
Practice Address - Street 1:5621 RIVERS AVE
Practice Address - Street 2:
Practice Address - City:NORTH CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29406-6022
Practice Address - Country:US
Practice Address - Phone:843-212-0733
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-06-10
Last Update Date:2024-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SCDGD.10822122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist