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General NPI Number Information
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NPI Number | 1639472806
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Entity Type | Organization
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Legal Business Name | MARK A. BAIRD D.D.S. INC
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Dates
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Enumeration Date | 12/09/2010
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Last Update Date | 12/09/2010
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Provider Practice Location Address
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Address Line | 4-976 KUHIO HWY
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City | KAPAA
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State | HI
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Zip | 96746-1572
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Country | US
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Telephone | 808-822-9393
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Fax | 808-822-7993
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Provider Business Mailing Address
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Address Line | 4-976 KUHIO HWY
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City | KAPAA
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State | HI
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Zip | 96746-1572
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Country | US
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Telephone | 808-822-9393
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Fax | 808-822-7993
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Authorized Official
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Title or Position | PRESIDENT
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Name | MARK A BAIRD
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Credential | D.D.S
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Telephone | 808-822-9393
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | TD-1091
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License Number State | HI
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