Provider Demographics
NPI:1992905061
Name:URREA, JORGE ALBERTO (DDS)
Entity type:Individual
Prefix:DR
First Name:JORGE
Middle Name:ALBERTO
Last Name:URREA
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 N RANCHO SANTA FE RD
Mailing Address - Street 2:SUITE 123
Mailing Address - City:SAN MARCOS
Mailing Address - State:CA
Mailing Address - Zip Code:92069-1279
Mailing Address - Country:US
Mailing Address - Phone:760-734-3660
Mailing Address - Fax:760-295-0436
Practice Address - Street 1:100 N RANCHO SANTA FE RD
Practice Address - Street 2:SUITE 123
Practice Address - City:SAN MARCOS
Practice Address - State:CA
Practice Address - Zip Code:92069-1279
Practice Address - Country:US
Practice Address - Phone:760-736-0035
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-18
Last Update Date:2020-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA54777122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist