MEDICARE: CHARLES URQUHART DDS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	122300000X	Dentist	DS026638L	PA

General Provider Information

NPI Number	:	1659520336
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHARLES URQUHART DDS

Provider Business Mailing Address
First Line	:	115 GRECIAN TER
Second Line	:
City	:	SINKING SPRING
State	:	PA
Zip	:	19608-1183
Country	:	US
Telephone Number	:	215-350-6548
Fax Number	:

Provider Business Practice Location Address
First Line	:	6140A WOODLAND AVE
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19142-3224
Country	:	US
Telephone Number	:	215-724-3000
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/17/2008
Last Update Date	:	07/18/2016

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