Provider Demographics
NPI:1265447908
Name:URBANIK, PETER (DDS)
Entity type:Individual
Prefix:DR
First Name:PETER
Middle Name:
Last Name:URBANIK
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 1:8044 CLAUDE CT
Mailing Address - Street 2:
Mailing Address - City:SYLVANIA
Mailing Address - State:OH
Mailing Address - Zip Code:43560-1095
Mailing Address - Country:US
Mailing Address - Phone:419-882-7599
Mailing Address - Fax:
Practice Address - Street 1:7135 SYLVANIA AVE
Practice Address - Street 2:1-A
Practice Address - City:SYLVANIA
Practice Address - State:OH
Practice Address - Zip Code:43560-3530
Practice Address - Country:US
Practice Address - Phone:419-885-1115
Practice Address - Fax:419-842-1656
Is Sole Proprietor?:No
Enumeration Date:2006-07-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH182961223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice