MEDICARE: DR. ROBERT FRANKLIN UTBERG D.M.D.

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	122300000X	Dentist	6956	CO

General Provider Information

NPI Number	:	1790849438
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ROBERT FRANKLIN UTBERG D.M.D.

Provider Business Mailing Address
First Line	:	17167 CEDAR GULCH PKWY
Second Line	:	SUITE 102
City	:	PARKER
State	:	CO
Zip	:	80134-4411
Country	:	US
Telephone Number	:	303-841-5313
Fax Number	:	303-841-5557

Provider Business Practice Location Address
First Line	:	17167 CEDAR GULCH PKWY
Second Line	:	SUITE 102
City	:	PARKER
State	:	CO
Zip	:	80134-4411
Country	:	US
Telephone Number	:	303-841-5313
Fax Number	:	303-841-5557

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

Provider Enumeration Date	:	12/20/2006
Last Update Date	:	11/18/2011

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