MEDICARE: DR. STEVEN P UTECHT DDS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry	14993	MI

General Provider Information

NPI Number	:	1609855204
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. STEVEN P UTECHT DDS

Provider Business Mailing Address
First Line	:	441 S LIVERNOIS RD
Second Line	:	SUITE 245
City	:	ROCHESTER HILLS
State	:	MI
Zip	:	48307-2584
Country	:	US
Telephone Number	:	248-651-7312
Fax Number	:	248-651-9317

Provider Business Practice Location Address
First Line	:	441 S LIVERNOIS RD
Second Line	:	SUITE 245
City	:	ROCHESTER HILLS
State	:	MI
Zip	:	48307-2584
Country	:	US
Telephone Number	:	248-651-7312
Fax Number	:	248-651-9317

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/11/2006
Last Update Date	:	07/08/2007

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