Provider Demographics
NPI:1215820881
Name:PRATHER, NATHANIEL (DDS)
Entity type:Individual
Prefix:DR
First Name:NATHANIEL
Middle Name:
Last Name:PRATHER
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:502 EAGLE ST
Mailing Address - Street 2:
Mailing Address - City:MOBERLY
Mailing Address - State:MO
Mailing Address - Zip Code:65270-5579
Mailing Address - Country:US
Mailing Address - Phone:816-349-7082
Mailing Address - Fax:
Practice Address - Street 1:202 S MAIN ST
Practice Address - Street 2:
Practice Address - City:HUNTSVILLE
Practice Address - State:MO
Practice Address - Zip Code:65259-1041
Practice Address - Country:US
Practice Address - Phone:660-277-4444
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-06-02
Last Update Date:2025-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO20250193441223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice