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General NPI Number Information
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NPI Number | 1790747558
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Entity Type | Organization
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Legal Business Name | DENTAL ASSOCIATES OF BARABOO, S.C.
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Dates
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Enumeration Date | 04/05/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 880 14TH ST
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City | BARABOO
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State | WI
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Zip | 53913-1540
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Country | US
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Telephone | 608-356-6611
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Fax | 608-356-5268
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Provider Business Mailing Address
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Address Line | 880 14TH ST P.O. BOX 558
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City | BARABOO
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State | WI
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Zip | 53913-1540
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Country | US
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Telephone | 608-356-6611
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Fax | 608-356-5268
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. ARNOLD J UTZINGER
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Credential | D.D.S.
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Telephone | 608-356-6611
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number |
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License Number State |
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