Individual
DR. DAVID CHARLES UTRIE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
105 N LINCOLN AVE, BEAVER DAM, WI 53916-2140
(920) 887-2427
(920) 887-2907
Mailing address
105 N LINCOLN AVE, BEAVER DAM, WI 53916-2140
(920) 887-2427
(920) 887-2907
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
5002046
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
33376200
—
WI
Enumeration date
07/17/2006
Last updated
07/09/2007
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