Provider Demographics
NPI:1437348554
Name:LEOW, NATALIE (BDS, MDSC, FRACDS)
Entity type:Individual
Prefix:DR
First Name:NATALIE
Middle Name:
Last Name:LEOW
Suffix:
Gender:F
Credentials:BDS, MDSC, FRACDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:188 LONGWOOD AVE
Mailing Address - Street 2:HARVARD SCHOOL OF DENTAL MEDICINE, REB 210
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02115-5819
Mailing Address - Country:US
Mailing Address - Phone:617-669-1699
Mailing Address - Fax:
Practice Address - Street 1:188 LONGWOOD AVE
Practice Address - Street 2:HARVARD SCHOOL OF DENTAL MEDICINE, REB 210
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02115-5819
Practice Address - Country:US
Practice Address - Phone:617-669-1699
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-10-15
Last Update Date:2007-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA97421223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA9742OtherBOARD OF DENTAL EXAMINERS