Provider Demographics
NPI:1629458674
Name:URGDENT DENTAL CARE
Entity Type:Organization
Organization Name:URGDENT DENTAL CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DPD
Authorized Official - Prefix:MR
Authorized Official - First Name:DONALD
Authorized Official - Middle Name:
Authorized Official - Last Name:DAVIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-926-9061
Mailing Address - Street 1:600 HEMPSTEAD TPKE
Mailing Address - Street 2:SUITE.100
Mailing Address - City:WEST HEMPSTEAD
Mailing Address - State:NY
Mailing Address - Zip Code:11552-1095
Mailing Address - Country:US
Mailing Address - Phone:516-292-3300
Mailing Address - Fax:
Practice Address - Street 1:600 HEMPSTEAD TPKE
Practice Address - Street 2:SUITE.100
Practice Address - City:WEST HEMPSTEAD
Practice Address - State:NY
Practice Address - Zip Code:11552-1095
Practice Address - Country:US
Practice Address - Phone:516-292-3300
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-06-04
Last Update Date:2015-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty