Provider Demographics
NPI:1831269356
Name:URQUIOLA, NANCY JOSEFINA (DDS, MS)
Entity type:Individual
Prefix:DR
First Name:NANCY
Middle Name:JOSEFINA
Last Name:URQUIOLA
Suffix:
Gender:F
Credentials:DDS, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2301 S HURON PKWY STE 1A
Mailing Address - Street 2:
Mailing Address - City:ANN ARBOR
Mailing Address - State:MI
Mailing Address - Zip Code:48104-5133
Mailing Address - Country:US
Mailing Address - Phone:734-973-7450
Mailing Address - Fax:734-973-1068
Practice Address - Street 1:2301 S HURON PKWY STE 1A
Practice Address - Street 2:
Practice Address - City:ANN ARBOR
Practice Address - State:MI
Practice Address - Zip Code:48104-5133
Practice Address - Country:US
Practice Address - Phone:734-973-7450
Practice Address - Fax:734-973-1068
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI29010132891223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice