Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 122300000X | Dentist | DS036541 | PA |
Y | 1223P0221X | Pediatric Dentist | DS036541 | PA |
NPI | 1003807249 |
---|---|
Provider Name | Dr. Natalie Beatriz De Barros |
First Address | King Of Prussia, PA 19406-3136 |
Second Address | King Of Prussia, PA 19406-3174 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 04/11/2005 |
Last Update Date | 03/04/2017 |