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General NPI Number Information
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NPI Number | 1518056662
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Entity Type | Organization
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Legal Business Name | TONYA WOODALL BAKER, D.M.D., INC.
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Dates
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Enumeration Date | 10/12/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 190 CURTIS PKWY NE SUITE A
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City | CALHOUN
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State | GA
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Zip | 30701-2062
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Country | US
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Telephone | 706-602-0540
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Fax | 706-602-2879
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Provider Business Mailing Address
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Address Line | 190 CURTIS PKWY NE SUITE A
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City | CALHOUN
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State | GA
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Zip | 30701-2062
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Country | US
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Telephone | 706-602-0540
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Fax | 706-602-2879
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Authorized Official
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Title or Position | PRESIDENT/ORTHODONTIST
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Name | DR. TONYA WOODALL BAKER
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Credential | D.M.D.
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Telephone | 706-602-0540
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number | 10874
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License Number State | GA
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