Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 1223S0112X | Oral and Maxillofacial Surgeon | DN 17306 | FL |
Y | 204E00000X | Oral & Maxillofacial Surgeon | ME 95024 | FL |
NPI | 1588734438 |
---|---|
Provider Name | Dr. Andrew Gregg Norkin |
First Address | Boca Raton, FL 33431-7209 |
Second Address | Boca Raton, FL 33431-7209 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 08/11/2006 |
Last Update Date | 06/10/2009 |