Provider Demographics
NPI:1639496094
Name:ELSON, NATALIA (DDS)
Entity Type:Individual
Prefix:DR
First Name:NATALIA
Middle Name:
Last Name:ELSON
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:150 ISLIP AVE STE 5
Mailing Address - Street 2:NATALIA ELSON DDS PC
Mailing Address - City:ISLIP
Mailing Address - State:NY
Mailing Address - Zip Code:11751-3222
Mailing Address - Country:US
Mailing Address - Phone:631-581-0216
Mailing Address - Fax:631-581-2415
Practice Address - Street 1:150 ISLIP AVE STE 5
Practice Address - Street 2:NATALIA ELSON DDS PC
Practice Address - City:ISLIP
Practice Address - State:NY
Practice Address - Zip Code:11751-3222
Practice Address - Country:US
Practice Address - Phone:631-581-0216
Practice Address - Fax:631-581-2415
Is Sole Proprietor?:No
Enumeration Date:2010-04-26
Last Update Date:2013-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY055703122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist