Provider Demographics
NPI:1710310032
Name:NORTON, JARIEL EUGENE
Entity Type:Individual
Prefix:DR
First Name:JARIEL
Middle Name:EUGENE
Last Name:NORTON
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 1:1206 NORTON AVE
Mailing Address - Street 2:
Mailing Address - City:HOMER
Mailing Address - State:LA
Mailing Address - Zip Code:71040-4234
Mailing Address - Country:US
Mailing Address - Phone:318-426-7822
Mailing Address - Fax:
Practice Address - Street 1:1206 NORTON AVE
Practice Address - Street 2:
Practice Address - City:HOMER
Practice Address - State:LA
Practice Address - Zip Code:71040-4234
Practice Address - Country:US
Practice Address - Phone:318-426-7822
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-08-11
Last Update Date:2022-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX294251223G0001X
LA65301223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice