Provider Demographics
NPI:1376229864
Name:NORBASH, LAYLA (DDS)
Entity Type:Individual
Prefix:
First Name:LAYLA
Middle Name:
Last Name:NORBASH
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 1:3613 CHARLESWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38122-4602
Mailing Address - Country:US
Mailing Address - Phone:615-720-6265
Mailing Address - Fax:
Practice Address - Street 1:122 E PLEASANT AVE
Practice Address - Street 2:
Practice Address - City:COVINGTON
Practice Address - State:TN
Practice Address - Zip Code:38019-2532
Practice Address - Country:US
Practice Address - Phone:901-476-2600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-06-27
Last Update Date:2023-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN122681223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice