Provider Demographics
NPI:1003982067
Name:UTHOFF, DAVID C (DMD)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:C
Last Name:UTHOFF
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:480 WOLVERINE DR STE 10
Mailing Address - Street 2:
Mailing Address - City:BAYFIELD
Mailing Address - State:CO
Mailing Address - Zip Code:81122-9653
Mailing Address - Country:US
Mailing Address - Phone:970-880-0688
Mailing Address - Fax:
Practice Address - Street 1:480 WOLVERINE DR STE 10
Practice Address - Street 2:
Practice Address - City:BAYFIELD
Practice Address - State:CO
Practice Address - Zip Code:81122-9653
Practice Address - Country:US
Practice Address - Phone:970-880-0688
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-28
Last Update Date:2020-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO002029501223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice