Provider Demographics
NPI:1851679393
Name:URLING, PETER (DDS)
Entity Type:Individual
Prefix:
First Name:PETER
Middle Name:
Last Name:URLING
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 1:19 S FRANKLIN ST
Mailing Address - Street 2:
Mailing Address - City:FARMINGTON
Mailing Address - State:MO
Mailing Address - Zip Code:63640-2503
Mailing Address - Country:US
Mailing Address - Phone:573-883-5781
Mailing Address - Fax:573-362-3389
Practice Address - Street 1:19 S. FRANKLIN ST.
Practice Address - Street 2:
Practice Address - City:FARMINGTON
Practice Address - State:MO
Practice Address - Zip Code:63640
Practice Address - Country:US
Practice Address - Phone:573-883-5781
Practice Address - Fax:573-362-3389
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-02
Last Update Date:2016-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO20110240841223G0001X, 1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice