Provider Demographics
NPI:1699848036
Name:URBANEK, MICHAEL ANTHONY (DDS)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:ANTHONY
Last Name:URBANEK
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 1:5801 TELEGRAPH RD
Mailing Address - Street 2:SUITE 1
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43612-4557
Mailing Address - Country:US
Mailing Address - Phone:419-478-4440
Mailing Address - Fax:419-478-4856
Practice Address - Street 1:5801 TELEGRAPH RD
Practice Address - Street 2:SUITE 1
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43612-4557
Practice Address - Country:US
Practice Address - Phone:419-478-4440
Practice Address - Fax:419-478-4856
Is Sole Proprietor?:No
Enumeration Date:2006-11-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH129961223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice