MEDICARE: DR. ERIC RANDOLPH BAUGH JR. DMD

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	DS-031221-L	PA
2	1223G0001X	General Practice Dentistry	12490	MD

General Provider Information

NPI Number	:	1992789242
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ERIC RANDOLPH BAUGH JR. DMD

Provider Business Mailing Address
First Line	:	PSC 80, BOX 13057
Second Line	:
City	:	APO
State	:	AP
Zip	:	96367
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	PSC 80, BOX 13057
Second Line	:
City	:	APO
State	:	AP
Zip	:	96367
Country	:	US
Telephone Number	:	011816430333152
Fax Number	:

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

Provider Enumeration Date	:	11/30/2005
Last Update Date	:	09/11/2025

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Directions to “ DR. ERIC RANDOLPH BAUGH JR. DMD” Practice Location

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