Provider Demographics
NPI:1477902153
Name:PLAGE, NATALEIGH HITT
Entity type:Individual
Prefix:
First Name:NATALEIGH
Middle Name:HITT
Last Name:PLAGE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5531 ELEANOR ROOSEVELT LN
Mailing Address - Street 2:
Mailing Address - City:WILLARD
Mailing Address - State:NC
Mailing Address - Zip Code:28478-6621
Mailing Address - Country:US
Mailing Address - Phone:910-285-0400
Mailing Address - Fax:910-567-5342
Practice Address - Street 1:5531 ELEANOR ROOSEVELT LN
Practice Address - Street 2:
Practice Address - City:WILLARD
Practice Address - State:NC
Practice Address - Zip Code:28478-6621
Practice Address - Country:US
Practice Address - Phone:910-285-0400
Practice Address - Fax:910-567-5342
Is Sole Proprietor?:No
Enumeration Date:2016-06-03
Last Update Date:2019-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC103331223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice