Provider Demographics
NPI:1457072498
Name:CORRADO, NATALIE (DMD)
Entity Type:Individual
Prefix:DR
First Name:NATALIE
Middle Name:
Last Name:CORRADO
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 1:1732 BRANDYWINE ST APT 3
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19130-3987
Mailing Address - Country:US
Mailing Address - Phone:412-916-4678
Mailing Address - Fax:
Practice Address - Street 1:2031 N BROAD ST STE 143
Practice Address - Street 2:
Practice Address - City:LANSDALE
Practice Address - State:PA
Practice Address - Zip Code:19446-1063
Practice Address - Country:US
Practice Address - Phone:215-343-3900
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-09-08
Last Update Date:2022-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS0438891223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice