Provider Demographics
NPI:1700393733
Name:UTOPIA DENTAL CARE,LLC
Entity Type:Organization
Organization Name:UTOPIA DENTAL CARE,LLC
Other - Org Name:UTOPIA DENTAL CARE, LLC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:DARLY
Authorized Official - Middle Name:G
Authorized Official - Last Name:BARKLEY
Authorized Official - Suffix:
Authorized Official - Credentials:DENTAL HYGIENIST
Authorized Official - Phone:505-800-9576
Mailing Address - Street 1:6721 SEVILLE PL NW
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87120-3034
Mailing Address - Country:US
Mailing Address - Phone:505-363-3435
Mailing Address - Fax:
Practice Address - Street 1:1100 LOMAS BLVD NW STE 1A
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87102-1878
Practice Address - Country:US
Practice Address - Phone:505-800-9576
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-12-28
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM1351124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes124Q00000XDental ProvidersDental HygienistGroup - Single Specialty