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General NPI Number Information
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NPI Number | 1831224245
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Entity Type | Organization
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Legal Business Name | J WILL BAKER DDS LLC
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Dates
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Enumeration Date | 02/23/2007
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Last Update Date | 02/24/2009
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Provider Practice Location Address
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Address Line | 1616 PULASKI PIKE NW
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City | HUNTSVILLE
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State | AL
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Zip | 35816-2534
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Country | US
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Telephone | 256-536-2771
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Fax | 256-539-5284
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Provider Business Mailing Address
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Address Line | PO BOX 5748
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City | HUNTSVILLE
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State | AL
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Zip | 35814-5748
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Country | US
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Telephone | 256-536-2771
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Fax | 256-539-5284
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Authorized Official
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Title or Position | OWNER
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Name | DR. J WILL BAKER
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Credential | DDS
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Telephone | 256-536-2771
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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 |
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License Number State |
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