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General NPI Number Information
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NPI Number | 1700393733
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Entity Type | Organization
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Legal Business Name | UTOPIA DENTAL CARE,LLC
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Dates
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Enumeration Date | 12/28/2017
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Last Update Date | 03/17/2018
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Provider Practice Location Address
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Address Line | 1100 LOMAS BLVD NW STE 1A
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City | ALBUQUERQUE
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State | NM
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Zip | 87102-1878
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Country | US
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Telephone | 505-800-9576
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Fax |
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Provider Business Mailing Address
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Address Line | 6721 SEVILLE PL NW
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City | ALBUQUERQUE
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State | NM
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Zip | 87120-3034
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Country | US
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Telephone | 505-363-3435
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MRS. DARLY G BARKLEY
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Credential | DENTAL HYGIENIST
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Telephone | 505-800-9576
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 124Q00000X
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Taxonomy Name | Dental Hygienist
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License Number | 1351
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License Number State | NM
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