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General NPI Number Information
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NPI Number | 1508541822
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Entity Type | Individual
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Provider Name | MARY ELIZABETH ROBY BAKER DMD
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Gender | Female
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Dates
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Enumeration Date | 06/15/2023
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Last Update Date | 07/18/2023
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Provider Practice Location Address
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Address Line | 265 HOPKINS CORNER DR
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City | WAYNESBORO
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State | GA
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Zip | 30830-3448
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Country | US
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Telephone | 706-554-1510
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Fax |
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Provider Business Mailing Address
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Address Line | 157 HIGH BRASS WAY
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City | HEPHZIBAH
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State | GA
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Zip | 30815-7228
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Country | US
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Telephone | 803-634-2981
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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 | 122300000X
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Taxonomy Name | Dentist
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License Number | DN123060
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License Number State | GA
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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 | DN123060
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License Number State | GA
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