MEDICARE: DR. REBECCA BAUDIN DDS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	122300000X	Dentist	7104	LA

General Provider Information

NPI Number	:	1194341917
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. REBECCA BAUDIN DDS

Provider Business Mailing Address
First Line	:	422 KADE ST STE 5
Second Line	:
City	:	JENNINGS
State	:	LA
Zip	:	70546-3657
Country	:	US
Telephone Number	:	337-824-8260
Fax Number	:

Provider Business Practice Location Address
First Line	:	422 KADE ST STE 5
Second Line	:
City	:	JENNINGS
State	:	LA
Zip	:	70546-3657
Country	:	US
Telephone Number	:	337-824-8260
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/17/2020
Last Update Date	:	07/11/2022

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