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General NPI Number Information
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NPI Number | 1760769483
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Entity Type | Individual
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Provider Name | LYDIA C BAIRD DMD
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Gender | Female
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Dates
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Enumeration Date | 11/09/2011
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Last Update Date | 06/03/2013
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Provider Practice Location Address
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Address Line | 100 CONTINENTAL DR
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City | ELIZABETHTOWN
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State | PA
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Zip | 17022-2260
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Country | US
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Telephone | 717-367-1332
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Fax |
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Provider Business Mailing Address
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Address Line | 100 CONTINENTAL DR
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City | ELIZABETHTOWN
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State | PA
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Zip | 17022-2260
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Country | US
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Telephone | 717-367-1332
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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 | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | DS038824
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License Number State | PA
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