Provider Demographics
NPI:1336833086
Name:DURAN, NATALIE NICOLE (DMD)
Entity type:Individual
Prefix:
First Name:NATALIE
Middle Name:NICOLE
Last Name:DURAN
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 1:2649 S MALCOLM AVE
Mailing Address - Street 2:
Mailing Address - City:ONTARIO
Mailing Address - State:CA
Mailing Address - Zip Code:91761-8708
Mailing Address - Country:US
Mailing Address - Phone:909-638-6097
Mailing Address - Fax:
Practice Address - Street 1:2649 S MALCOLM AVE
Practice Address - Street 2:
Practice Address - City:ONTARIO
Practice Address - State:CA
Practice Address - Zip Code:91761-8708
Practice Address - Country:US
Practice Address - Phone:909-638-6097
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-06-06
Last Update Date:2023-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program