Organization
J D UTLEY JR DMD PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JACK D UTLEY JR. DMD (PRESIDENT)
(814) 833-5322
Entity
Organization
Contact information
Practice address
3900 ZUCK ROAD, ERIE, PA 16506
(814) 833-5322
(814) 838-8718
Mailing address
3900 ZUCK ROAD, ERIE, PA 16506
(814) 833-5322
(814) 838-8718
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
DS018914L
PA
Other
Enumeration date
04/26/2007
Last updated
08/22/2020
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