Healthcare Provider Details

I. General information

NPI: 1649269176
Provider Name (Legal Business Name): STEVEN D URELES DMD, MS
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 10/18/2005
Last Update Date: 07/09/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

190 HEMPSTEAD ST
NEW LONDON CT
06320-6248
US

IV. Provider business mailing address

190 HEMPSTEAD ST
NEW LONDON CT
06320-6248
US

V. Phone/Fax

Practice location:
  • Phone: 860-447-3216
  • Fax: 860-701-6019
Mailing address:
  • Phone: 860-447-3216
  • Fax: 860-701-6019

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223P0221X
TaxonomyPediatric Dentistry
License Number7348
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: