Provider Demographics
NPI:1760944839
Name:URIARTE DENTAL CORPORATION
Entity Type:Organization
Organization Name:URIARTE DENTAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:
Authorized Official - First Name:MARICELA
Authorized Official - Middle Name:
Authorized Official - Last Name:URIARTE
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:619-600-4450
Mailing Address - Street 1:2937 BEYER BLVD
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92154-4604
Mailing Address - Country:US
Mailing Address - Phone:619-600-4450
Mailing Address - Fax:619-600-4425
Practice Address - Street 1:2937 BEYER BLVD
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92154-4604
Practice Address - Country:US
Practice Address - Phone:619-600-4450
Practice Address - Fax:619-600-4425
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-04-05
Last Update Date:2019-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty