Provider Demographics
NPI:1669521696
Name:STRELTSOV, NATALIA G (DMD)
Entity type:Individual
Prefix:
First Name:NATALIA
Middle Name:G
Last Name:STRELTSOV
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:PO BOX 984
Mailing Address - Street 2:
Mailing Address - City:HANOVER
Mailing Address - State:NH
Mailing Address - Zip Code:03755
Mailing Address - Country:US
Mailing Address - Phone:603-643-8998
Mailing Address - Fax:603-643-1212
Practice Address - Street 1:307 ROUTE 120
Practice Address - Street 2:UNIT E2
Practice Address - City:LEBANON
Practice Address - State:NH
Practice Address - Zip Code:03766
Practice Address - Country:US
Practice Address - Phone:603-643-8998
Practice Address - Fax:603-643-1212
Is Sole Proprietor?:No
Enumeration Date:2007-01-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH3310122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist