Provider Demographics
NPI:1952086027
Name:DAVID URBANAWIZ, DMD, LLC
Entity Type:Organization
Organization Name:DAVID URBANAWIZ, DMD, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:EDWARD
Authorized Official - Last Name:URBANAWIZ
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:803-648-9511
Mailing Address - Street 1:598 SILVER BLUFF RD STE 1
Mailing Address - Street 2:
Mailing Address - City:AIKEN
Mailing Address - State:SC
Mailing Address - Zip Code:29803-6012
Mailing Address - Country:US
Mailing Address - Phone:803-648-9511
Mailing Address - Fax:
Practice Address - Street 1:598 SILVER BLUFF RD STE 1
Practice Address - Street 2:
Practice Address - City:AIKEN
Practice Address - State:SC
Practice Address - Zip Code:29803-6012
Practice Address - Country:US
Practice Address - Phone:803-648-9511
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-06-16
Last Update Date:2023-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental