Provider Demographics
NPI:1912179094
Name:WARREN URDA DDS
Entity Type:Organization
Organization Name:WARREN URDA DDS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:WARREN
Authorized Official - Middle Name:THOMAS
Authorized Official - Last Name:URDA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:907-276-3804
Mailing Address - Street 1:237 EAST FIREWEED LANE SUITE 101
Mailing Address - Street 2:
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99503-2000
Mailing Address - Country:US
Mailing Address - Phone:907-276-3804
Mailing Address - Fax:
Practice Address - Street 1:237 E FIREWEED LN STE 101
Practice Address - Street 2:
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99503-2000
Practice Address - Country:US
Practice Address - Phone:907-276-3804
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-28
Last Update Date:2008-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK82910261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental