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General NPI Number Information
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NPI Number | 1073905949
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Entity Type | Organization
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Legal Business Name | MICHAEL A. BAIKER, D.D.S
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Dates
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Enumeration Date | 03/02/2015
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Last Update Date | 03/02/2015
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Provider Practice Location Address
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Address Line | 240 4TH AVE
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City | INDIALANTIC
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State | FL
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Zip | 32903-3114
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Country | US
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Telephone | 321-956-0230
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Fax |
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Provider Business Mailing Address
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Address Line | 240 4TH AVE
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City | INDIALANTIC
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State | FL
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Zip | 32903
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Country | US
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Telephone | 321-956-0230
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Fax |
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | MRS. DIANE ST-PIERRE-BAIKER
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Credential |
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Telephone | 321-956-0230
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 12651
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License Number State | FL
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