Provider Demographics
NPI:1598966335
Name:BARBARA J. UTERMARK, DMD, P.C.
Entity Type:Organization
Organization Name:BARBARA J. UTERMARK, DMD, P.C.
Other - Org Name:UTERMARK ORTHODONTICS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DOCTOR - ORTHODONTIST
Authorized Official - Prefix:
Authorized Official - First Name:BARBARA
Authorized Official - Middle Name:J
Authorized Official - Last Name:UTERMARK
Authorized Official - Suffix:
Authorized Official - Credentials:DMD PC
Authorized Official - Phone:706-860-5884
Mailing Address - Street 1:4469-B COLUMBIA ROAD
Mailing Address - Street 2:
Mailing Address - City:MARTINEZ
Mailing Address - State:GA
Mailing Address - Zip Code:30907-4573
Mailing Address - Country:US
Mailing Address - Phone:706-860-5884
Mailing Address - Fax:706-860-2100
Practice Address - Street 1:4469-B COLUMBIA ROAD
Practice Address - Street 2:
Practice Address - City:MARTINEZ
Practice Address - State:GA
Practice Address - Zip Code:30907-4573
Practice Address - Country:US
Practice Address - Phone:706-860-5884
Practice Address - Fax:706-860-2100
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-30
Last Update Date:2008-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA85931223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Single Specialty