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General NPI Number Information
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NPI Number | 1003034372
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Entity Type | Individual
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Provider Name | JESSICA MARIA BAEZ D.D.S.
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Gender | Female
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Dates
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Enumeration Date | 04/23/2007
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Last Update Date | 05/16/2008
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Provider Practice Location Address
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Address Line | 25300 BOROUGH PARK DR
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City | SPRING
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State | TX
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Zip | 77380-3552
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Country | US
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Telephone | 281-296-0052
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Fax | 281-296-0118
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Provider Business Mailing Address
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Address Line | 26615 OAK RIDGE DR
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City | THE WOODLANDS
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State | TX
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Zip | 77380-1968
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Country | US
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Telephone | 281-296-8600
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Fax | 281-296-9509
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 22845
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 1223P0300X
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Taxonomy Name | Periodontics
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License Number | 22845
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License Number State | TX
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