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General NPI Number Information
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NPI Number | 1376657619
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Entity Type | Individual
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Provider Name | DORSEY W BAKER D.D.S.
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Gender | Male
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Dates
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Enumeration Date | 08/17/2006
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Last Update Date | 06/08/2009
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Provider Practice Location Address
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Address Line | 18275 N. 59 AVE STE 150
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City | GLENDALE
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State | AZ
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Zip | 85308
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Country | US
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Telephone | 602-942-0623
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Fax | 602-942-2409
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Provider Business Mailing Address
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Address Line | 18275 N. 59 AVE STE 150
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City | GLENDALE
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State | AZ
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Zip | 85308
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Country | US
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Telephone | 602-942-0623
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Fax | 602-942-2409
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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 | AZ3760
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License Number State | AZ
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Taxonomy #2
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | AZ 3760
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License Number State | AZ
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Taxonomy #3
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | AZ3760
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License Number State | AZ
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