Provider Demographics
NPI:1770681959
Name:UTKE, CALVIN DALE (DDS)
Entity Type:Individual
Prefix:DR
First Name:CALVIN
Middle Name:DALE
Last Name:UTKE
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5770 FLINTRIDGE DR
Mailing Address - Street 2:SUITE 210
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80918-1881
Mailing Address - Country:US
Mailing Address - Phone:719-593-8701
Mailing Address - Fax:719-593-9258
Practice Address - Street 1:5770 FLINTRIDGE DR
Practice Address - Street 2:SUITE 210
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80918-1881
Practice Address - Country:US
Practice Address - Phone:719-593-8701
Practice Address - Fax:719-593-9258
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO1058361223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO105836OtherDENTAL LICENSE