Provider Demographics
NPI:1023026002
Name:URBINA, EDWARD WILLIAM (DDS)
Entity Type:Individual
Prefix:
First Name:EDWARD
Middle Name:WILLIAM
Last Name:URBINA
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 1:32920 ROAD 140
Mailing Address - Street 2:
Mailing Address - City:VISALIA
Mailing Address - State:CA
Mailing Address - Zip Code:93292-9318
Mailing Address - Country:US
Mailing Address - Phone:559-284-3050
Mailing Address - Fax:559-635-9383
Practice Address - Street 1:32920 ROAD 140
Practice Address - Street 2:
Practice Address - City:VISALIA
Practice Address - State:CA
Practice Address - Zip Code:93292-9318
Practice Address - Country:US
Practice Address - Phone:559-284-3050
Practice Address - Fax:559-635-9383
Is Sole Proprietor?:No
Enumeration Date:2006-08-04
Last Update Date:2015-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA29759122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist