Provider Demographics
NPI:1659534253
Name:URBANOWICZ, TOMMY (DMD)
Entity Type:Individual
Prefix:
First Name:TOMMY
Middle Name:
Last Name:URBANOWICZ
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1811 LOUETTA RD
Mailing Address - Street 2:
Mailing Address - City:SPRING
Mailing Address - State:TX
Mailing Address - Zip Code:77388-4731
Mailing Address - Country:US
Mailing Address - Phone:281-350-1600
Mailing Address - Fax:281-350-4562
Practice Address - Street 1:12114 GRAND ARCHES LN
Practice Address - Street 2:
Practice Address - City:HUMBLE
Practice Address - State:TX
Practice Address - Zip Code:77346-3685
Practice Address - Country:US
Practice Address - Phone:618-772-8731
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-07-03
Last Update Date:2011-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX24118122300000X, 1223G0001X, 390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
No122300000XDental ProvidersDentist
No1223G0001XDental ProvidersDentistGeneral Practice