Provider Demographics
NPI:1437782505
Name:DR. DAVID C UTHOFF DMD
Entity Type:Organization
Organization Name:DR. DAVID C UTHOFF DMD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:UTHOFF
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:970-880-0688
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:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-02-18
Last Update Date:2020-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental