Provider Demographics
NPI:1659336071
Name:NORRIS, WILLIAM D SR (DMD)
Entity Type:Individual
Prefix:MR
First Name:WILLIAM
Middle Name:D
Last Name:NORRIS
Suffix:SR
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:3590 HARRISON
Mailing Address - Street 2:#2
Mailing Address - City:OGDEN
Mailing Address - State:UT
Mailing Address - Zip Code:84403
Mailing Address - Country:US
Mailing Address - Phone:801-392-7176
Mailing Address - Fax:801-392-9828
Practice Address - Street 1:3590 HARRISON
Practice Address - Street 2:#2
Practice Address - City:OGDEN
Practice Address - State:UT
Practice Address - Zip Code:84403
Practice Address - Country:US
Practice Address - Phone:801-392-7776
Practice Address - Fax:801-392-9828
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT1344981223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
200112OtherALTIUS
200112OtherALTIUS