Provider Demographics
NPI:1760043764
Name:NORTON, ETHAN BRENT (DMD)
Entity Type:Individual
Prefix:DR
First Name:ETHAN
Middle Name:BRENT
Last Name:NORTON
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7745 TIMBERLINE OVERLOOK
Mailing Address - Street 2:
Mailing Address - City:CUMMING
Mailing Address - State:GA
Mailing Address - Zip Code:30041-2157
Mailing Address - Country:US
Mailing Address - Phone:678-451-2122
Mailing Address - Fax:
Practice Address - Street 1:2011 N MAIN ST
Practice Address - Street 2:
Practice Address - City:HIGH POINT
Practice Address - State:NC
Practice Address - Zip Code:27262-2133
Practice Address - Country:US
Practice Address - Phone:336-860-3210
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-06-21
Last Update Date:2019-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC11482122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist