MEDICARE: DR. LAKSHMI NATHI D.D.S

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry	DI021792	NJ

General Provider Information

NPI Number	:	1497844807
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. LAKSHMI NATHI D.D.S

Provider Business Mailing Address
First Line	:	2 LYLE FARM LN
Second Line	:
City	:	MILLSTONE TOWNSHIP
State	:	NJ
Zip	:	07726-9304
Country	:	US
Telephone Number	:	732-446-0566
Fax Number	:

Provider Business Practice Location Address
First Line	:	3700 KENNEDY BLVD
Second Line	:
City	:	UNION CITY
State	:	NJ
Zip	:	07087-2529
Country	:	US
Telephone Number	:	201-866-3737
Fax Number	:	201-866-6266

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/12/2006
Last Update Date	:	07/08/2007

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