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General NPI Number Information
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NPI Number | 1871057968
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Entity Type | Organization
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Legal Business Name | BAKER ORTHODONTICS PLLC
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Dates
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Enumeration Date | 01/23/2019
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Last Update Date | 01/23/2019
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Provider Practice Location Address
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Address Line | 18 BUCK RD
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City | HANOVER
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State | NH
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Zip | 03755-2700
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Country | US
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Telephone | 603-643-1552
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Fax |
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Provider Business Mailing Address
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Address Line | 18 BUCK RD
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City | HANOVER
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State | NH
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Zip | 03755-2700
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Country | US
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Telephone | 603-643-1552
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | GREGORY L BAKER
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Credential |
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Telephone | 603-491-5095
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number |
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License Number State |
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