Provider Demographics
NPI:1245650944
Name:ZACHARY B NORRIS D.D.S. P.S.
Entity type:Organization
Organization Name:ZACHARY B NORRIS D.D.S. P.S.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ZACHARY
Authorized Official - Middle Name:
Authorized Official - Last Name:NORRIS
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:360-679-7227
Mailing Address - Street 1:620 EAST WHIDBEY AVENUE
Mailing Address - Street 2:SUITE #100
Mailing Address - City:OAK-HARBOR
Mailing Address - State:WA
Mailing Address - Zip Code:98277
Mailing Address - Country:US
Mailing Address - Phone:360-679-7227
Mailing Address - Fax:360-675-7278
Practice Address - Street 1:620 EAST WHIDBEY AVENUE
Practice Address - Street 2:SUITE #100
Practice Address - City:OAK-HARBOR
Practice Address - State:WA
Practice Address - Zip Code:98277
Practice Address - Country:US
Practice Address - Phone:360-679-7227
Practice Address - Fax:360-675-7278
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-04-21
Last Update Date:2018-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADE60093997261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental