Provider Demographics
NPI:1609920040
Name:URUKALO-HARSHMAN, NATASA (DDS)
Entity type:Individual
Prefix:DR
First Name:NATASA
Middle Name:
Last Name:URUKALO-HARSHMAN
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 1:976 3 MILE RD NW STE A
Mailing Address - Street 2:
Mailing Address - City:GRAND RAPIDS
Mailing Address - State:MI
Mailing Address - Zip Code:49544-8203
Mailing Address - Country:US
Mailing Address - Phone:616-784-4038
Mailing Address - Fax:616-785-9501
Practice Address - Street 1:976 3 MILE RD NW STE A
Practice Address - Street 2:
Practice Address - City:GRAND RAPIDS
Practice Address - State:MI
Practice Address - Zip Code:49544-8203
Practice Address - Country:US
Practice Address - Phone:616-784-4038
Practice Address - Fax:616-785-9501
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-23
Last Update Date:2024-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI29010176921223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice