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General NPI Number Information
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NPI Number | 1134276207
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Entity Type | Individual
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Provider Name | ALBERT A NATELLI JR. DDS
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Gender | Male
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Dates
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Enumeration Date | 01/04/2007
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Last Update Date | 10/26/2022
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Provider Practice Location Address
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Address Line | 2060 SAM RITTENBERG BLVD BLDG 6192ND
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City | CHARLESTON
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State | SC
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Zip | 29407-4616
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Country | US
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Telephone | 843-876-9267
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Fax |
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Provider Business Mailing Address
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Address Line | 5004 YARROW CT
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City | SUMMERVILLE
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State | SC
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Zip | 29485-8682
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Country | US
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Telephone | 608-919-4962
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 007729
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License Number State | CT
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Taxonomy #2
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 51
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License Number State | SC
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