Healthcare Provider Details

I. General information

NPI: 1770287773
Provider Name (Legal Business Name): BRIAN THOMAS URBAN DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/27/2023
Last Update Date: 08/06/2025
Certification Date: 08/06/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

41 S STATE RD
UPPER DARBY PA
19082-2028
US

IV. Provider business mailing address

302 COVENTRY CT
HOLLIDAYSBURG PA
16648-2931
US

V. Phone/Fax

Practice location:
  • Phone: 610-789-2410
  • Fax:
Mailing address:
  • Phone: 814-329-7561
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License NumberDS044884
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: