Provider Demographics
NPI:1881826683
Name:NORRIS, ZACHARY BOYD (DDS)
Entity Type:Individual
Prefix:
First Name:ZACHARY
Middle Name:BOYD
Last Name:NORRIS
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:830 METCALF STREET
Mailing Address - Street 2:
Mailing Address - City:SEORO-WOOLLEY
Mailing Address - State:WA
Mailing Address - Zip Code:98284
Mailing Address - Country:US
Mailing Address - Phone:360-855-0352
Mailing Address - Fax:
Practice Address - Street 1:830 METCALF STREET
Practice Address - Street 2:
Practice Address - City:SEORO-WOOLLEY
Practice Address - State:WA
Practice Address - Zip Code:98284
Practice Address - Country:US
Practice Address - Phone:360-855-0351
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-08-13
Last Update Date:2009-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADE600939971223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice