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General NPI Number Information
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NPI Number | 1306889555
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Entity Type | Individual
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Provider Name | JAMES JEFFERY BALDI DDS
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Gender | Male
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Dates
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Enumeration Date | 06/14/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 3813 N STERLING AVE
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City | PEORIA
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State | IL
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Zip | 61615-4230
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Country | US
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Telephone | 309-686-6400
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Fax |
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Provider Business Mailing Address
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Address Line | 2400 VETERANS RD
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City | MORTON
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State | IL
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Zip | 61550-9594
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Country | US
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Telephone | 309-263-2748
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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 | 1223E0200X
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Taxonomy Name | Endodontics
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License Number |
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License Number State | IL
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