Provider Demographics
NPI:1962522839
Name:CLINTON J. NORRIS, D.D.S., P.C.
Entity type:Organization
Organization Name:CLINTON J. NORRIS, D.D.S., P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:DR
Authorized Official - First Name:CLINTON
Authorized Official - Middle Name:JOSEPH
Authorized Official - Last Name:NORRIS
Authorized Official - Suffix:III
Authorized Official - Credentials:DDS
Authorized Official - Phone:804-747-0044
Mailing Address - Street 1:4445 COX RD
Mailing Address - Street 2:
Mailing Address - City:GLEN ALLEN
Mailing Address - State:VA
Mailing Address - Zip Code:23060-3326
Mailing Address - Country:US
Mailing Address - Phone:804-747-0044
Mailing Address - Fax:804-968-4871
Practice Address - Street 1:4445 COX RD
Practice Address - Street 2:
Practice Address - City:GLEN ALLEN
Practice Address - State:VA
Practice Address - Zip Code:23060-3326
Practice Address - Country:US
Practice Address - Phone:804-747-0044
Practice Address - Fax:804-968-4871
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CENTRAL VIRGINIA DENTAL CARE, PLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-04-01
Last Update Date:2016-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0401007441122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty