Provider Demographics
NPI:1326409707
Name:NATURALLY YOU DENTISTRY
Entity Type:Organization
Organization Name:NATURALLY YOU DENTISTRY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JAVANA
Authorized Official - Middle Name:
Authorized Official - Last Name:COSNER
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:269-962-5774
Mailing Address - Street 1:485 COLUMBIA AVE E
Mailing Address - Street 2:SUITE 12
Mailing Address - City:BATTLE CREEK
Mailing Address - State:MI
Mailing Address - Zip Code:49014-5499
Mailing Address - Country:US
Mailing Address - Phone:269-962-5774
Mailing Address - Fax:269-962-5353
Practice Address - Street 1:485 COLUMBIA AVE E
Practice Address - Street 2:SUITE 12
Practice Address - City:BATTLE CREEK
Practice Address - State:MI
Practice Address - Zip Code:49014-5499
Practice Address - Country:US
Practice Address - Phone:269-962-5774
Practice Address - Fax:269-962-5353
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-03-14
Last Update Date:2016-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI29010208301223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty