MEDICARE: GERALD A BAUDIN II D.D.S.

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	LA5546	LA

General Provider Information

NPI Number	:	1932325941
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GERALD A BAUDIN II D.D.S.

Provider Business Mailing Address
First Line	:	2623 SOUTH DR
Second Line	:
City	:	ABBEVILLE
State	:	LA
Zip	:	70510-4044
Country	:	US
Telephone Number	:	337-893-6033
Fax Number	:	337-893-6074

Provider Business Practice Location Address
First Line	:	2623 SOUTH DR
Second Line	:
City	:	ABBEVILLE
State	:	LA
Zip	:	70510-4044
Country	:	US
Telephone Number	:	337-893-6033
Fax Number	:	337-893-6074

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

Provider Enumeration Date	:	04/18/2007
Last Update Date	:	07/08/2007

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