Provider Demographics
NPI:1629456884
Name:DRS. URBANIK, BARRICKLOW & SCHULTZ, D.D.S., INC.
Entity Type:Organization
Organization Name:DRS. URBANIK, BARRICKLOW & SCHULTZ, D.D.S., INC.
Other - Org Name:BROOKVIEW DENTAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:BRAD
Authorized Official - Middle Name:D
Authorized Official - Last Name:BARRICKLOW
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:419-885-1115
Mailing Address - Street 1:7135 SYLVANIA AVE
Mailing Address - Street 2:STE: 1-A
Mailing Address - City:SYLVANIA
Mailing Address - State:OH
Mailing Address - Zip Code:43560-5510
Mailing Address - Country:US
Mailing Address - Phone:419-885-1115
Mailing Address - Fax:419-842-1656
Practice Address - Street 1:7135 SYLVANIA AVE
Practice Address - Street 2:STE: 1-A
Practice Address - City:SYLVANIA
Practice Address - State:OH
Practice Address - Zip Code:43560-5510
Practice Address - Country:US
Practice Address - Phone:419-885-1115
Practice Address - Fax:419-842-1656
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-05-08
Last Update Date:2016-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH018296261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH1629456884Medicare NSC