Provider Demographics
NPI:1922274208
Name:FRASER, NATASHYA M (DDS)
Entity Type:Individual
Prefix:DR
First Name:NATASHYA
Middle Name:M
Last Name:FRASER
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 1:1001 WEST STREET
Mailing Address - Street 2:
Mailing Address - City:CARTHAGE
Mailing Address - State:NY
Mailing Address - Zip Code:13619
Mailing Address - Country:US
Mailing Address - Phone:315-493-1000
Mailing Address - Fax:718-901-8121
Practice Address - Street 1:3 BRIDGE STREET
Practice Address - Street 2:
Practice Address - City:CARTHAGE
Practice Address - State:NY
Practice Address - Zip Code:13619
Practice Address - Country:US
Practice Address - Phone:315-493-3510
Practice Address - Fax:718-901-8121
Is Sole Proprietor?:No
Enumeration Date:2008-05-06
Last Update Date:2013-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYP593111223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice