Healthcare Provider Details

I. General information

NPI: 1316032485
Provider Name (Legal Business Name): DANNY PAUL BAIRD IV DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/04/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4020 FM 2181
HICKORY CREEK TX
75065-7526
US

IV. Provider business mailing address

4020 FM 2181
HICKORY CREEK TX
75065-7526
US

V. Phone/Fax

Practice location:
  • Phone: 940-321-2088
  • Fax: 940-497-3225
Mailing address:
  • Phone: 940-321-2088
  • Fax: 940-497-3225

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number15010
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: