Provider Demographics
NPI:1891824413
Name:URBANKOVA, ALICE (DDS, PHD)
Entity Type:Individual
Prefix:DR
First Name:ALICE
Middle Name:
Last Name:URBANKOVA
Suffix:
Gender:F
Credentials:DDS, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:630 5TH AVE, SUITE 1860
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10111
Mailing Address - Country:US
Mailing Address - Phone:212-765-7340
Mailing Address - Fax:
Practice Address - Street 1:630 5TH AVE STE 1860
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10111-1866
Practice Address - Country:US
Practice Address - Phone:212-765-7340
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-02
Last Update Date:2013-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY053127-11223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice