MEDICARE: DR. NATALIA SLUSKY DDS

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	46972	CA

General Provider Information

NPI Number	:	1740243179
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. NATALIA SLUSKY DDS

Provider Business Mailing Address
First Line	:	PO BOX 1149
Second Line	:
City	:	SIERRA MADRE
State	:	CA
Zip	:	91025-4149
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	210 S GRAND AVE
Second Line	:	SUITE 308
City	:	GLENDORA
State	:	CA
Zip	:	91741-4205
Country	:	US
Telephone Number	:	626-914-0500
Fax Number	:

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

Provider Enumeration Date	:	04/07/2006
Last Update Date	:	07/08/2007

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