Provider Demographics
NPI:1558421610
Name:CORDICE, NORMAN HEATHERSALL JR (DDS)
Entity Type:Individual
Prefix:DR
First Name:NORMAN
Middle Name:HEATHERSALL
Last Name:CORDICE
Suffix:JR
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:3803 HYDES FERRY RD
Mailing Address - Street 2:SUITE A
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37218-2645
Mailing Address - Country:US
Mailing Address - Phone:615-732-1097
Mailing Address - Fax:615-864-8970
Practice Address - Street 1:3803 HYDES FERRY RD
Practice Address - Street 2:SUITE A
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37218-2645
Practice Address - Country:US
Practice Address - Phone:615-732-1097
Practice Address - Fax:615-864-8970
Is Sole Proprietor?:No
Enumeration Date:2006-12-11
Last Update Date:2013-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNDS0000004031208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
621857610OtherDELTA DENTAL
138536020OtherDORAL
14732OtherTENNCARE