Provider Demographics
NPI:1750405189
Name:ATLEVSKI GATES, NATASHA (DDS)
Entity type:Individual
Prefix:DR
First Name:NATASHA
Middle Name:
Last Name:ATLEVSKI GATES
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 1:30141 CHERRY HILL RD
Mailing Address - Street 2:
Mailing Address - City:INKSTER
Mailing Address - State:MI
Mailing Address - Zip Code:48141-4019
Mailing Address - Country:US
Mailing Address - Phone:734-729-1160
Mailing Address - Fax:734-729-1162
Practice Address - Street 1:30141 CHERRY HILL RD
Practice Address - Street 2:
Practice Address - City:INKSTER
Practice Address - State:MI
Practice Address - Zip Code:48141-4019
Practice Address - Country:US
Practice Address - Phone:734-729-1160
Practice Address - Fax:734-729-1162
Is Sole Proprietor?:No
Enumeration Date:2007-03-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI29010194261223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice