Provider Demographics
NPI:1366577462
Name:LANGFORD, NORRIS M JR (D,MD)
Entity type:Individual
Prefix:
First Name:NORRIS
Middle Name:M
Last Name:LANGFORD
Suffix:JR
Gender:M
Credentials:D,MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:5207 COMMERCE CROSSINGS DR
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40229-2183
Mailing Address - Country:US
Mailing Address - Phone:502-968-7878
Mailing Address - Fax:502-968-2378
Practice Address - Street 1:5207 COMMERCE CROSSINGS DR
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40229-2183
Practice Address - Country:US
Practice Address - Phone:502-968-7878
Practice Address - Fax:502-968-2378
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY38511223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics