Provider Demographics
NPI:1164593893
Name:NEU, NATALIE
Entity Type:Individual
Prefix:DR
First Name:NATALIE
Middle Name:
Last Name:NEU
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:132 E DREXEL AVE
Mailing Address - Street 2:
Mailing Address - City:OAK CREEK
Mailing Address - State:WI
Mailing Address - Zip Code:53154-2123
Mailing Address - Country:US
Mailing Address - Phone:414-762-9010
Mailing Address - Fax:414-570-5492
Practice Address - Street 1:132 E DREXEL AVE
Practice Address - Street 2:
Practice Address - City:OAK CREEK
Practice Address - State:WI
Practice Address - Zip Code:53154-2123
Practice Address - Country:US
Practice Address - Phone:414-762-9010
Practice Address - Fax:414-570-5492
Is Sole Proprietor?:No
Enumeration Date:2006-11-13
Last Update Date:2010-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI5768-0151223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice