Provider Demographics
NPI:1104029073
Name:BRANSON, NORMA L (DDS)
Entity Type:Individual
Prefix:DR
First Name:NORMA
Middle Name:L
Last Name:BRANSON
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5250 MURPHY CANYON RD STE 122
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92123-4367
Mailing Address - Country:US
Mailing Address - Phone:858-268-8112
Mailing Address - Fax:
Practice Address - Street 1:5250 MURPHY CANYON RD STE 122
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92123-4367
Practice Address - Country:US
Practice Address - Phone:858-268-8112
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-06-07
Last Update Date:2016-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA53897122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist