Provider Demographics
NPI:1407988488
Name:EBNER, NORMAN W (DDS)
Entity Type:Individual
Prefix:DR
First Name:NORMAN
Middle Name:W
Last Name:EBNER
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6605 W 38TH AVE
Mailing Address - Street 2:
Mailing Address - City:WHEAT RIDGE
Mailing Address - State:CO
Mailing Address - Zip Code:80033-4905
Mailing Address - Country:US
Mailing Address - Phone:303-424-6421
Mailing Address - Fax:303-456-7682
Practice Address - Street 1:6605 W 38TH AVE
Practice Address - Street 2:
Practice Address - City:WHEAT RIDGE
Practice Address - State:CO
Practice Address - Zip Code:80033-4905
Practice Address - Country:US
Practice Address - Phone:303-424-6421
Practice Address - Fax:303-456-7682
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO54481223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice