Healthcare Provider Details
I. General information
NPI: 1003807249
Provider Name (Legal Business Name): NATALIE BEATRIZ DE BARROS D.M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 11/04/2005
Last Update Date: 04/03/2017
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
357 S GULPH RD SUITE 100
KING OF PRUSSIA PA
19406-3174
US
IV. Provider business mailing address
357 S GULPH RD SUITE 100
KING OF PRUSSIA PA
19406-3136
US
V. Phone/Fax
- Phone: 610-337-2325
- Fax:
- Phone: 610-337-2325
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 1223P0221X |
| Taxonomy | Pediatric Dentistry |
| License Number | DS036541 |
| License Number State | PA |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 122300000X |
| Taxonomy | Dentist |
| License Number | DS036541 |
| License Number State | PA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: