Provider Demographics
NPI:1932451341
Name:NORMAN B. FINE, D.M.D., P.C.
Entity Type:Organization
Organization Name:NORMAN B. FINE, D.M.D., P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:BRANDY
Authorized Official - Middle Name:L
Authorized Official - Last Name:MERRITT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:864-299-5900
Mailing Address - Street 1:517 W BUTLER RD
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29607-4833
Mailing Address - Country:US
Mailing Address - Phone:864-299-5900
Mailing Address - Fax:864-299-5033
Practice Address - Street 1:517 W BUTLER RD
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:SC
Practice Address - Zip Code:29607-4833
Practice Address - Country:US
Practice Address - Phone:864-299-5900
Practice Address - Fax:864-299-5033
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:NORMAN B. FINE, D.M.D., P.C.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2012-10-09
Last Update Date:2012-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC4480-7621223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0300XDental ProvidersDentistPeriodonticsGroup - Single Specialty