Provider Demographics
NPI:1669539433
Name:URBANO BEER, GRACE C (DDS)
Entity type:Individual
Prefix:
First Name:GRACE
Middle Name:C
Last Name:URBANO BEER
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:512 KENSINGTON DR
Mailing Address - Street 2:
Mailing Address - City:FILLMORE
Mailing Address - State:CA
Mailing Address - Zip Code:93015-1334
Mailing Address - Country:US
Mailing Address - Phone:805-524-3966
Mailing Address - Fax:805-524-3654
Practice Address - Street 1:512 KENSINGTON DR
Practice Address - Street 2:
Practice Address - City:FILLMORE
Practice Address - State:CA
Practice Address - Zip Code:93015-1334
Practice Address - Country:US
Practice Address - Phone:805-524-3966
Practice Address - Fax:805-524-3954
Is Sole Proprietor?:No
Enumeration Date:2007-01-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA371761223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAB3717601OtherDENTICAL