Healthcare Provider Details

I. General information

NPI: 1881711463
Provider Name (Legal Business Name): CURT J. URBAN D.D.S.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/26/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14000 US HIGHWAY 1
SEBASTIAN FL
32958-3297
US

IV. Provider business mailing address

14000 US HIGHWAY 1
SEBASTIAN FL
32958-3297
US

V. Phone/Fax

Practice location:
  • Phone: 772-589-3127
  • Fax: 772-589-3127
Mailing address:
  • Phone: 772-589-3127
  • Fax: 772-589-3127

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License NumberDN10183
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: