Provider Demographics
NPI:1912470501
Name:KRISTINA W. NATERNICOLA, DDS PLLC
Entity Type:Organization
Organization Name:KRISTINA W. NATERNICOLA, DDS PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ DENTIST
Authorized Official - Prefix:
Authorized Official - First Name:KRISTINA
Authorized Official - Middle Name:W
Authorized Official - Last Name:NATERNICOLA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:304-765-2522
Mailing Address - Street 1:PO BOX 485
Mailing Address - Street 2:
Mailing Address - City:SUTTON
Mailing Address - State:WV
Mailing Address - Zip Code:26601-0485
Mailing Address - Country:US
Mailing Address - Phone:304-765-2522
Mailing Address - Fax:
Practice Address - Street 1:304 RIVERVIEW DR
Practice Address - Street 2:
Practice Address - City:SUTTON
Practice Address - State:WV
Practice Address - Zip Code:26601-1343
Practice Address - Country:US
Practice Address - Phone:304-765-2522
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-01-07
Last Update Date:2019-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental