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General NPI Number Information
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NPI Number | 1518275387
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Entity Type | Individual
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Provider Name | SUZANNE BALDWIN DMD
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Gender | Female
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Dates
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Enumeration Date | 09/15/2010
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Last Update Date | 02/14/2022
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Provider Practice Location Address
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Address Line | 1711 EAST CENTRAL TEXAS EXPY SUITE 102
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City | KILEEN
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State | TX
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Zip | 76541
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Country | US
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Telephone | 254-213-6300
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 11832
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City | KILLEEN
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State | TX
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Zip | 76547
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Country | US
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Telephone | 254-213-6300
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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 | 25314
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License Number State | TX
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