Provider Demographics
NPI:1871224832
Name:CARLOS URIBE DDS PLC
Entity Type:Organization
Organization Name:CARLOS URIBE DDS PLC
Other - Org Name:CARLOS URIBE DDS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:
Authorized Official - First Name:CARLOS
Authorized Official - Middle Name:E
Authorized Official - Last Name:URIBE
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:989-832-8889
Mailing Address - Street 1:207 HAROLD ST
Mailing Address - Street 2:
Mailing Address - City:MIDLAND
Mailing Address - State:MI
Mailing Address - Zip Code:48640-4418
Mailing Address - Country:US
Mailing Address - Phone:989-832-8889
Mailing Address - Fax:
Practice Address - Street 1:207 HAROLD ST
Practice Address - Street 2:
Practice Address - City:MIDLAND
Practice Address - State:MI
Practice Address - Zip Code:48640-4418
Practice Address - Country:US
Practice Address - Phone:989-832-8889
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-06-21
Last Update Date:2023-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
No1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI4651501Medicaid