Provider Demographics
NPI:1073243853
Name:HARRIS, NATALIE ALYSE (DMD, MBA)
Entity Type:Individual
Prefix:DR
First Name:NATALIE
Middle Name:ALYSE
Last Name:HARRIS
Suffix:
Gender:F
Credentials:DMD, MBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2038 LEE ROAD 137 LOT 138
Mailing Address - Street 2:
Mailing Address - City:AUBURN
Mailing Address - State:AL
Mailing Address - Zip Code:36832-7505
Mailing Address - Country:US
Mailing Address - Phone:256-338-8178
Mailing Address - Fax:
Practice Address - Street 1:1204 OGLETREE VILLAGE LN
Practice Address - Street 2:
Practice Address - City:AUBURN
Practice Address - State:AL
Practice Address - Zip Code:36830-2960
Practice Address - Country:US
Practice Address - Phone:334-887-0099
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-06-14
Last Update Date:2022-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALD-0007072-C1122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist