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General NPI Number Information
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NPI Number | 1831278241
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Entity Type | Organization
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Legal Business Name | MARIANA BAKER DDS PC
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Dates
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Enumeration Date | 11/04/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1431 MCHENRY RD 106
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City | BUFFALO GROVE
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State | IL
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Zip | 60089-1372
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Country | US
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Telephone | 847-883-8707
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Fax |
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Provider Business Mailing Address
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Address Line | 1431 MCHENRY RD 106
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City | BUFFALO GROVE
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State | IL
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Zip | 60089-1372
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Country | US
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Telephone | 847-883-8707
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MARIANA BAKER
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Credential | DDS
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Telephone | 847-883-8707
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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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