Organization
DR. JACK URSIC, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. CONNIE PRUITT (OFFICE MANAGER)
(410) 326-4078
Entity
Organization
Contact information
Practice address
10025 HG TRUEMAN RD, LUSBY, MD 20657-2861
(410) 326-4078
(410) 326-9311
Mailing address
10025 HG TRUEMAN RD, LUSBY, MD 20657-2861
(410) 326-4078
(410) 326-9311
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
7289
MD
Other
Enumeration date
04/24/2007
Last updated
08/22/2020
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