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General NPI Number Information
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NPI Number | 1427566223
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Entity Type | Organization
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Legal Business Name | BALDWIN DENTISTRY PA
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Dates
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Enumeration Date | 01/15/2018
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Last Update Date | 01/15/2018
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Provider Practice Location Address
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Address Line | 135 US HIGHWAY 27 S
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City | SOUTH BAY
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State | FL
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Zip | 33493-2213
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Country | US
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Telephone | 561-996-0033
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Fax | 561-996-0044
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Provider Business Mailing Address
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Address Line | 135 US HIGHWAY 27 S
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City | SOUTH BAY
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State | FL
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Zip | 33493-2213
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Country | US
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Telephone | 561-996-0033
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Fax | 561-996-0044
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Authorized Official
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Title or Position | DENTIST
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Name | DR. ANTHONY BALDWIN
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Credential | DDS
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Telephone | 561-996-0033
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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 | DN21975
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | DN21975
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License Number State | FL
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