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General NPI Number Information
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NPI Number | 1356674139
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Entity Type | Individual
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Provider Name | CLAUDIO L. URQUIAGA D.D.S.
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Gender | Male
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Dates
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Enumeration Date | 09/11/2009
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Last Update Date | 09/11/2009
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Provider Practice Location Address
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Address Line | 10136 BELL INN LN
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City | ELLICOTT CITY
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State | MD
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Zip | 21042-5651
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Country | US
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Telephone | 410-948-3462
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Fax |
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Provider Business Mailing Address
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Address Line | 10136 BELL INN LN
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City | ELLICOTT CITY
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State | MD
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Zip | 21042-5651
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Country | US
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Telephone | 410-948-3462
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 0401412420
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License Number State | VA
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