Provider Demographics
NPI:1558401349
Name:NORKIN, GARY STEVEN
Entity Type:Individual
Prefix:DR
First Name:GARY
Middle Name:STEVEN
Last Name:NORKIN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3170 N FEDERAL HWY
Mailing Address - Street 2:#113
Mailing Address - City:LIGHTHOUSE PT
Mailing Address - State:FL
Mailing Address - Zip Code:33064
Mailing Address - Country:US
Mailing Address - Phone:954-943-5640
Mailing Address - Fax:954-943-5618
Practice Address - Street 1:3170 N FEDERAL HWY
Practice Address - Street 2:#113
Practice Address - City:LIGHTHOUSE PT
Practice Address - State:FL
Practice Address - Zip Code:33064
Practice Address - Country:US
Practice Address - Phone:954-943-5640
Practice Address - Fax:954-943-5618
Is Sole Proprietor?:No
Enumeration Date:2007-02-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN73161223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics