Provider Demographics
NPI:1356674139
Name:URQUIAGA, CLAUDIO L (DDS)
Entity Type:Individual
Prefix:
First Name:CLAUDIO
Middle Name:L
Last Name:URQUIAGA
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 1:10136 BELL INN LN
Mailing Address - Street 2:
Mailing Address - City:ELLICOTT CITY
Mailing Address - State:MD
Mailing Address - Zip Code:21042-5651
Mailing Address - Country:US
Mailing Address - Phone:410-948-3462
Mailing Address - Fax:
Practice Address - Street 1:10136 BELL INN LN
Practice Address - Street 2:
Practice Address - City:ELLICOTT CITY
Practice Address - State:MD
Practice Address - Zip Code:21042-5651
Practice Address - Country:US
Practice Address - Phone:410-948-3462
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-09-11
Last Update Date:2009-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0401412420122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist