Provider Demographics
NPI:1275545287
Name:URDA, WARREN THOMAS (DDS)
Entity Type:Individual
Prefix:DR
First Name:WARREN
Middle Name:THOMAS
Last Name:URDA
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 1:237 E FIREWEED LN
Mailing Address - Street 2:SUITE # 101
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99503-2025
Mailing Address - Country:US
Mailing Address - Phone:907-276-3804
Mailing Address - Fax:907-276-3808
Practice Address - Street 1:237 E FIREWEED LN
Practice Address - Street 2:SUITE # 101
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99503-2025
Practice Address - Country:US
Practice Address - Phone:907-276-3804
Practice Address - Fax:907-276-3808
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK6461223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice