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Provider Information for 1154590123



DR. LIA P URREGO DDS

Gender: FEMALE

Individual NPI: 1154590123

Calendar Last Updated: 2008-09-09

Details

Name Value
NPI 1154590123
Enumeration Date 2008-02-25
NPI Type 1 - Individual
Sole Proprietor YES
Status Active
Mailing Address 950 WASHINGTON ST SUITE J
GAINESVILLE, GA 30501-3542
United States

Phone: 770-534-6933 | Fax: 770-535-7882
View Map External Link
Primary Practice Address 950 WASHINGTON ST SUITE J
GAINESVILLE, GA 30501-3542
United States

Phone: 770-534-6933 | Fax: 770-535-7882
View Map External Link
Health Information Exchange
Endpoint Type Endpoint Endpoint Description Use Content Type Affiliation Endpoint Location
Other Identifiers
Issuer State Number
Taxonomy
Primary Taxonomy Selected Taxonomy State License Number
Yes 1223G0001X - Dentist General Practice GA DN013677