Provider Demographics
NPI:1649365875
Name:LURIE, NATALIA (DDS)
Entity type:Individual
Prefix:MRS
First Name:NATALIA
Middle Name:
Last Name:LURIE
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 1:1840 AVONDALE AVE
Mailing Address - Street 2:SUITE 2
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95825
Mailing Address - Country:US
Mailing Address - Phone:916-488-8962
Mailing Address - Fax:916-488-8536
Practice Address - Street 1:1840 AVONDALE AVE
Practice Address - Street 2:SUITE 2
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95825
Practice Address - Country:US
Practice Address - Phone:916-488-8962
Practice Address - Fax:916-488-8536
Is Sole Proprietor?:No
Enumeration Date:2006-10-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA46876122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist