Dr. Jack Ursic, PA
Organization Active NPI General Practice Dentistry · Lusby, MD
NPI 1194944744 · NPPES record last updated Aug 22, 2020
Key facts
- NPI
- 1194944744
- Entity type
- Organization (NPI type 2)
- Primary specialty
- General Practice Dentistry 1223G0001X
- License
- 7289 (MD)
- Legal business name
- DR. JACK URSIC, PA
- Practice address
- 10025 HG Trueman Rd
Lusby, MD 20657-2861 - Phone
- (410) 326-4078
- Fax
- (410) 326-9311
- NPI assigned
- Apr 24, 2007
- Organization subpart
- No
Authorized official
- Name
- Ms. Connie Pruitt
- Title
- Office Manager
- Phone
- (410) 326-4078
National Provider Directory
Locations
10025 Hg Trueman Rd
Lusby, MD 20657
Phone (410) 326-4078
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry |
1223G0001X | 7289 | MD | Yes |
Addresses
Primary practice location
10025 HG Trueman Rd
Lusby, MD 20657-2861
Mailing address
10025 HG Trueman Rd
Lusby, MD 20657-2861
Phone (410) 326-4078
Other providers in Lusby, MD
- Tolulope Dehinbo
- Sarah Delaney
- Dependable Care
- Christina Dawn Donner
- Joshua Dougherty
- James Matthew Duffy
- Eric Elder
- Melody Nnenna Elele
- Rashida Sylona Franklin
- Friendly Pharmacy LLC
All providers in Lusby, MD · General Practice Dentistry in Maryland
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 22, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.