Individual
MR. EUGENE RICHARD UTRIE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
144 WEST MADISON STREET, PROFESSIONAL BUILDING, WATERLOO, WI 53594-1397
(920) 478-3636
Mailing address
144 WEST MADISON STREET, PROFESSIONAL BUILDING, WATERLOO, WI 53594-1397
(920) 478-3636
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
5000697
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5000697
LICENSE
WI
Enumeration date
12/06/2006
Last updated
03/07/2023
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