Individual
MR. MIKE J UTLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.M.D.
Contact information
Practice address
528 EAST MAPLE STREET, CANEYVILLE, KY 42721
(270) 879-3055
Mailing address
528 EAST MAPLE STREET, P.O. BOX 215, CANEYVILLE, KY 42721
(270) 879-3055
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
4030
KY
Other
Enumeration date
11/17/2006
Last updated
07/08/2007
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