Provider Demographics
NPI:1922157130
Name:UHRIK, GEOFFREY EUGENE (DDS)
Entity Type:Individual
Prefix:DR
First Name:GEOFFREY
Middle Name:EUGENE
Last Name:UHRIK
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 1:2430 TORRID AVE
Mailing Address - Street 2:
Mailing Address - City:MODESTO
Mailing Address - State:CA
Mailing Address - Zip Code:95358-1214
Mailing Address - Country:US
Mailing Address - Phone:209-521-5435
Mailing Address - Fax:209-521-4160
Practice Address - Street 1:3300 TULLY RD STE A6
Practice Address - Street 2:
Practice Address - City:MODESTO
Practice Address - State:CA
Practice Address - Zip Code:95350-0847
Practice Address - Country:US
Practice Address - Phone:209-521-5435
Practice Address - Fax:209-521-4160
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA230531223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice