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General NPI Number Information
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NPI Number | 1114017209
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Entity Type | Individual
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Provider Name | ERIC FREDERICK BAUMAN DMD, MS
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Gender | Male
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Dates
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Enumeration Date | 10/13/2006
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Last Update Date | 09/25/2024
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Provider Practice Location Address
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Address Line | 1090 GOAT SPRINGS ROAD
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City | TAOS
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State | NM
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Zip | 87571
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Country | US
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Telephone | 575-758-6955
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Fax |
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Provider Business Mailing Address
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Address Line | 1090 GOAT SPRINGS ROAD
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City | TAOS
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State | NM
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Zip | 87571
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Country | US
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Telephone | 575-758-6955
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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 | 122300000X
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Taxonomy Name | Dentist
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License Number | D8840
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License Number State | OR
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Taxonomy #2
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | DN24628
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License Number State | FL
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