Healthcare Provider Details

I. General information

NPI: 1700954856
Provider Name (Legal Business Name): WENDELL PHILIP URLING DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/30/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

60 WESTWOOD AVE SUITE 270
WATERBURY CT
06708
US

IV. Provider business mailing address

60 WESTWOOD AVE SUITE 270
WATERBURY CT
06708
US

V. Phone/Fax

Practice location:
  • Phone: 203-753-9905
  • Fax: 203-753-9246
Mailing address:
  • Phone: 203-753-9905
  • Fax: 203-753-9246

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223P0300X
TaxonomyPeriodontics
License Number7189
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: