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General NPI Number Information
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NPI Number | 1336369974
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Entity Type | Individual
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Provider Name | DANIELLE MICHELLE BAKER D.D.S.
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Gender | Female
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Dates
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Enumeration Date | 04/26/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 110 MONTAUK HWY
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City | MORICHES
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State | NY
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Zip | 11955-1407
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Country | US
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Telephone | 631-878-4488
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Fax | 631-878-7330
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Provider Business Mailing Address
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Address Line | 336 ARTIST LAKE DR
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City | MIDDLE ISLAND
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State | NY
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Zip | 11953-2329
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Country | US
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Telephone | 631-926-9402
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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 | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 051303
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License Number State | NY
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