Provider Demographics
NPI:1689899197
Name:ANTHONY E. URLAKIS DDS., SC
Entity Type:Organization
Organization Name:ANTHONY E. URLAKIS DDS., SC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PERIODONTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:ANTHONY
Authorized Official - Middle Name:
Authorized Official - Last Name:URLAKIS
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:608-754-6852
Mailing Address - Street 1:111 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:JANESVILLE
Mailing Address - State:WI
Mailing Address - Zip Code:53545-3096
Mailing Address - Country:US
Mailing Address - Phone:608-754-6852
Mailing Address - Fax:608-314-1178
Practice Address - Street 1:111 N MAIN ST
Practice Address - Street 2:
Practice Address - City:JANESVILLE
Practice Address - State:WI
Practice Address - Zip Code:53545-3096
Practice Address - Country:US
Practice Address - Phone:608-754-6852
Practice Address - Fax:608-314-1178
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-17
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI5000576-015261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental