Provider Demographics
NPI:1386786606
Name:NATTESTAD, ANDERS (DDS, PHD)
Entity type:Individual
Prefix:DR
First Name:ANDERS
Middle Name:
Last Name:NATTESTAD
Suffix:
Gender:M
Credentials:DDS, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:155 5TH ST
Mailing Address - Street 2:SUITE 350
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94103-2919
Mailing Address - Country:US
Mailing Address - Phone:415-351-7191
Mailing Address - Fax:415-749-3339
Practice Address - Street 1:155 5TH ST
Practice Address - Street 2:SUITE 350
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94103-2919
Practice Address - Country:US
Practice Address - Phone:415-351-7191
Practice Address - Fax:415-749-3339
Is Sole Proprietor?:No
Enumeration Date:2007-02-13
Last Update Date:2014-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CASP 2471223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery