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General NPI Number Information
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NPI Number | 1336289131
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Entity Type | Individual
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Provider Name | MINDY BALDWIN
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Gender | Female
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Dates
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Enumeration Date | 02/08/2007
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Last Update Date | 07/31/2024
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Provider Practice Location Address
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Address Line | 505 FORRESTER DR SE
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City | DAWSON
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State | GA
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Zip | 39842-2006
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Country | US
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Telephone | 229-995-2990
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Fax |
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Provider Business Mailing Address
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Address Line | 3286 GA HIGHWAY 266
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City | CUTHBERT
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State | GA
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Zip | 39840-5100
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Country | US
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Telephone | 292-869-7341
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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 | 124Q00000X
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Taxonomy Name | Dental Hygienist
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License Number | 20830
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License Number State | CA
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