Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223D0001X | Dental Public Health | DEN2343 | ME |
NPI | 1265747919 |
---|---|
Provider Name | Dr. Philip B Norton |
First Address | Ellsworth, ME 04605-3210 |
Second Address | Ellsworth, ME 04605-3210 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/08/2010 |
Last Update Date | 18/08/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
106190099 | (05) | ME |