Provider Demographics
NPI:1245542752
Name:MAKAROVA, NATALIA I (DMD)
Entity type:Individual
Prefix:DR
First Name:NATALIA
Middle Name:I
Last Name:MAKAROVA
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1585 SW MARLOW AVE
Mailing Address - Street 2:STE 120
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97225-5176
Mailing Address - Country:US
Mailing Address - Phone:503-297-1687
Mailing Address - Fax:503-292-4575
Practice Address - Street 1:1585 SW MARLOW AVE
Practice Address - Street 2:STE 120
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97225-5176
Practice Address - Country:US
Practice Address - Phone:503-297-1687
Practice Address - Fax:503-292-4575
Is Sole Proprietor?:No
Enumeration Date:2010-07-13
Last Update Date:2011-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORD93371223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice