Healthcare Provider Details

I. General information

NPI: 1073446142
Provider Name (Legal Business Name): CLAY DONALD BAKER DMD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/08/2026
Last Update Date: 06/08/2026
Certification Date: 06/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1283 SIMS ST
GAINESVILLE GA
30501-3851
US

IV. Provider business mailing address

1283 SIMS ST
GAINESVILLE GA
30501-3851
US

V. Phone/Fax

Practice location:
  • Phone: 770-299-3387
  • Fax:
Mailing address:
  • Phone: 770-299-3387
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License NumberDN124163
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: