Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223S0112X | Oral and Maxillofacial Surgeon | D13628 | MN |
N | 204E00000X | Oral & Maxillofacial Surgeon | D13628 | MN |
NPI | 1497013031 |
---|---|
Provider Name | Dr. Marcus J Urza |
First Address | Minneapolis, MN 55415-1623 |
Second Address | Minneapolis, MN 55415 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/05/2012 |
Last Update Date | 30/05/2018 |