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General NPI Number Information
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NPI Number | 1356083273
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Entity Type | Organization
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Legal Business Name | ERIC T BAUM DMD
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Dates
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Enumeration Date | 04/11/2022
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Last Update Date | 12/03/2024
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Provider Practice Location Address
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Address Line | 310 COMMACK RD
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City | COMMACK
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State | NY
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Zip | 11725-3451
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Country | US
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Telephone | 631-906-2227
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Fax |
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Provider Business Mailing Address
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Address Line | 8 MUNSEE WAY
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City | COMMACK
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State | NY
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Zip | 11725-1345
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Country | US
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Telephone | 631-888-3939
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. ERIC T BAUM
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Credential | DMD
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Telephone | 631-906-2227
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number |
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License Number State |
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