Healthcare Provider Details

I. General information

NPI: 1265340590
Provider Name (Legal Business Name): TRAVIS S. BALDWIN, DDS, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/28/2026
Last Update Date: 08/28/2026
Certification Date: 08/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1260 N 200 E STE 9
LOGAN UT
84341-2382
US

IV. Provider business mailing address

1260 N 200 E STE 9
LOGAN UT
84341-2382
US

V. Phone/Fax

Practice location:
  • Phone: 435-752-8000
  • Fax:
Mailing address:
  • Phone: 435-752-8000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number
License Number State

VIII. Authorized Official

Name: TRAVIS BALDWIN
Title or Position: OWNER
Credential: DDS
Phone: 435-752-8000