Provider Demographics
NPI:1720182314
Name:MCHUGH, ANGELICA GARCIA (DDS)
Entity Type:Individual
Prefix:
First Name:ANGELICA
Middle Name:GARCIA
Last Name:MCHUGH
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:ANGELICA
Other - Middle Name:
Other - Last Name:GARCIA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DDS
Mailing Address - Street 1:950 25TH ST STE A
Mailing Address - Street 2:
Mailing Address - City:OGDEN
Mailing Address - State:UT
Mailing Address - Zip Code:84401-6823
Mailing Address - Country:US
Mailing Address - Phone:801-395-7090
Mailing Address - Fax:801-395-7099
Practice Address - Street 1:950 25TH ST STE A
Practice Address - Street 2:
Practice Address - City:OGDEN
Practice Address - State:UT
Practice Address - Zip Code:84401-6823
Practice Address - Country:US
Practice Address - Phone:801-395-7090
Practice Address - Fax:801-395-7099
Is Sole Proprietor?:No
Enumeration Date:2006-09-12
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX220331223G0001X
UT83975259922122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
No1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX89D684OtherBCBS
TX30137659OtherDPS REGISTRATION
TXBG9012167OtherDEA REGISTRATION
TXU16341Medicare UPIN
TX89D684OtherBCBS