Provider Demographics
NPI:1790747558
Name:DENTAL ASSOCIATES OF BARABOO, S.C.
Entity Type:Organization
Organization Name:DENTAL ASSOCIATES OF BARABOO, S.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ARNOLD
Authorized Official - Middle Name:J
Authorized Official - Last Name:UTZINGER
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:608-356-6611
Mailing Address - Street 1:880 14TH ST
Mailing Address - Street 2:P.O. BOX 558
Mailing Address - City:BARABOO
Mailing Address - State:WI
Mailing Address - Zip Code:53913-1540
Mailing Address - Country:US
Mailing Address - Phone:608-356-6611
Mailing Address - Fax:608-356-5268
Practice Address - Street 1:880 14TH ST
Practice Address - Street 2:
Practice Address - City:BARABOO
Practice Address - State:WI
Practice Address - Zip Code:53913-1540
Practice Address - Country:US
Practice Address - Phone:608-356-6611
Practice Address - Fax:608-356-5268
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-05
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty