| NPI | 1770998130 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CALVIN DALE UTKE President 719-593-8701 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CO 105836) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: CO 00008770) |
| Enumeration Date | 2014-06-24 |
| Last Update Date | 2014-06-24 |