Provider Demographics
NPI:1720972706
Name:PRATHER DYNASTY LLC
Entity type:Organization
Organization Name:PRATHER DYNASTY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:NATHANIEL
Authorized Official - Middle Name:
Authorized Official - Last Name:PRATHER
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:816-349-7082
Mailing Address - Street 1:502 EAGLE ST
Mailing Address - Street 2:
Mailing Address - City:MOBERLY
Mailing Address - State:MO
Mailing Address - Zip Code:65270-5579
Mailing Address - Country:US
Mailing Address - Phone:816-349-7082
Mailing Address - Fax:
Practice Address - Street 1:202 S MAIN ST
Practice Address - Street 2:
Practice Address - City:HUNTSVILLE
Practice Address - State:MO
Practice Address - Zip Code:65259-1041
Practice Address - Country:US
Practice Address - Phone:660-277-4444
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-06-05
Last Update Date:2025-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental