Provider Demographics
NPI:1255667564
Name:ALICE BARKY D.D.S. INC.
Entity Type:Organization
Organization Name:ALICE BARKY D.D.S. INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:ALICE
Authorized Official - Middle Name:
Authorized Official - Last Name:BARKY
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:805-368-7447
Mailing Address - Street 1:PO BOX 5669
Mailing Address - Street 2:
Mailing Address - City:SANTA MARIA
Mailing Address - State:CA
Mailing Address - Zip Code:93456-5669
Mailing Address - Country:US
Mailing Address - Phone:805-368-7447
Mailing Address - Fax:805-623-5574
Practice Address - Street 1:1023 W MAIN ST
Practice Address - Street 2:
Practice Address - City:SANTA MARIA
Practice Address - State:CA
Practice Address - Zip Code:93458-4237
Practice Address - Country:US
Practice Address - Phone:805-623-5535
Practice Address - Fax:805-623-5574
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-10-20
Last Update Date:2015-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA51285122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty