Healthcare Provider Details

I. General information

NPI: 1134222987
Provider Name (Legal Business Name): MARIANNE MURRAY URBANSKI DMD,MSCD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/07/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

546 S BROAD ST SUITE 3A
MERIDEN CT
06450-6600
US

IV. Provider business mailing address

265 OREGON RD
CHESHIRE CT
06410-1827
US

V. Phone/Fax

Practice location:
  • Phone: 203-630-1312
  • Fax: 203-235-6673
Mailing address:
  • Phone: 203-271-0794
  • Fax: 203-235-6673

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223P0300X
TaxonomyPeriodontics
License Number7003
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: