Provider Demographics
NPI:1629695069
Name:DURGIN, NATHAN B (DMD)
Entity Type:Individual
Prefix:
First Name:NATHAN
Middle Name:B
Last Name:DURGIN
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:103 NEW MEADOW RUN DR
Mailing Address - Street 2:
Mailing Address - City:FARMINGTON
Mailing Address - State:PA
Mailing Address - Zip Code:15437-1391
Mailing Address - Country:US
Mailing Address - Phone:724-749-1517
Mailing Address - Fax:
Practice Address - Street 1:103 NEW MEADOW RUN DR
Practice Address - Street 2:
Practice Address - City:FARMINGTON
Practice Address - State:PA
Practice Address - Zip Code:15437-1391
Practice Address - Country:US
Practice Address - Phone:724-749-1517
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-07-01
Last Update Date:2022-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY062036122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist