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General NPI Number Information
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NPI Number | 1972706554
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Entity Type | Individual
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Provider Name | JAVIER URQUIOLA D.D.S.
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Gender | Male
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Dates
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Enumeration Date | 06/09/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 163 ENGLE ST STE 2
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City | ENGLEWOOD
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State | NJ
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Zip | 07631-2530
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Country | US
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Telephone | 201-568-2532
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Fax | 201-568-3810
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Provider Business Mailing Address
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Address Line | 219 TOM HUNTER RD
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City | FORT LEE
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State | NJ
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Zip | 07024-5301
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Country | US
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Telephone | 201-482-4017
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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 | 1223P0700X
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Taxonomy Name | Prosthodontics
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License Number | 22DI01820400
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License Number State | NJ
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