Provider Demographics
NPI:1144435488
Name:KALTESKI, NATHAN BERNARD (DDS)
Entity type:Individual
Prefix:
First Name:NATHAN
Middle Name:BERNARD
Last Name:KALTESKI
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:116 ILAINA DR
Mailing Address - Street 2:
Mailing Address - City:MOOSIC
Mailing Address - State:PA
Mailing Address - Zip Code:18507-1829
Mailing Address - Country:US
Mailing Address - Phone:570-347-4277
Mailing Address - Fax:
Practice Address - Street 1:3940 LOCUST LN
Practice Address - Street 2:
Practice Address - City:HARRISBURG
Practice Address - State:PA
Practice Address - Zip Code:17109-4023
Practice Address - Country:US
Practice Address - Phone:717-545-5787
Practice Address - Fax:717-545-5491
Is Sole Proprietor?:No
Enumeration Date:2007-05-11
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS0352171223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0018979380003Medicaid
PA0018979380005Medicaid