MEDICARE: BAUST AND JOYCE PLLC

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	1223G0001X	General Practice Dentistry

General Provider Information

NPI Number	:	1255071544
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BAUST AND JOYCE PLLC

Provider Business Mailing Address
First Line	:	2905 BRIARCLIFFE RD
Second Line	:
City	:	WINSTON SALEM
State	:	NC
Zip	:	27106-3076
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2905 BRIARCLIFFE RD
Second Line	:
City	:	WINSTON SALEM
State	:	NC
Zip	:	27106-3076
Country	:	US
Telephone Number	:	336-407-3347
Fax Number	:

Authorized Official
Title or Position	:	CO-OWNER
Name	:	DR. EDWARD MCARTHUR BAUST III
Credential	:	DMD
Telephone Number	:	404-729-9508

Provider Enumeration Date	:	04/01/2022
Last Update Date	:	04/01/2022

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