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General NPI Number Information
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NPI Number | 1083757157
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Entity Type | Individual
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Provider Name | MARVIN BAER DDS
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Gender | Male
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Dates
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Enumeration Date | 02/15/2007
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Last Update Date | 03/16/2016
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Provider Practice Location Address
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Address Line | 2106 FALLSTON RD
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City | FALLSTON
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State | MD
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Zip | 21047-1442
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Country | US
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Telephone | 410-893-0513
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Fax |
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Provider Business Mailing Address
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Address Line | 2605 GUNPOWDER FARMS RD
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City | FALLSTON
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State | MD
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Zip | 21047-2205
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Country | US
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Telephone | 410-877-3567
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Fax |
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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 | 1223P0700X
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Taxonomy Name | Prosthodontics
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License Number | 9195
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License Number State | MD
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