Provider Demographics
NPI:1013999309
Name:URA, PATRICIA B (DDS)
Entity Type:Individual
Prefix:DR
First Name:PATRICIA
Middle Name:B
Last Name:URA
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:DR
Other - First Name:PATRICIA
Other - Middle Name:M
Other - Last Name:BRAGA
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DDS
Mailing Address - Street 1:6105 CAHILL AVE
Mailing Address - Street 2:
Mailing Address - City:INVER GROVE HEIGHTS
Mailing Address - State:MN
Mailing Address - Zip Code:55076-1525
Mailing Address - Country:US
Mailing Address - Phone:651-451-9101
Mailing Address - Fax:651-451-9887
Practice Address - Street 1:6105 CAHILL AVE
Practice Address - Street 2:
Practice Address - City:INVER GROVE HEIGHTS
Practice Address - State:MN
Practice Address - Zip Code:55076-1525
Practice Address - Country:US
Practice Address - Phone:651-451-9101
Practice Address - Fax:651-451-9887
Is Sole Proprietor?:No
Enumeration Date:2005-11-14
Last Update Date:2013-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN9521122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN74522250OtherMEDICAL ASSISTANCE
MN74522250OtherMEDICAL ASSISTANCE