Provider Demographics
NPI:1356424204
Name:NATTERER, XIAOSONG WANG (DDS)
Entity type:Individual
Prefix:DR
First Name:XIAOSONG
Middle Name:WANG
Last Name:NATTERER
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 1:2000 FRANKLIN ST
Mailing Address - Street 2:
Mailing Address - City:LEBANON
Mailing Address - State:OR
Mailing Address - Zip Code:97355-3970
Mailing Address - Country:US
Mailing Address - Phone:541-757-0755
Mailing Address - Fax:
Practice Address - Street 1:2000 FRANKLIN ST
Practice Address - Street 2:
Practice Address - City:LEBANON
Practice Address - State:OR
Practice Address - Zip Code:97355-3970
Practice Address - Country:US
Practice Address - Phone:541-757-0755
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORD79591223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice