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General NPI Number Information
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NPI Number | 1942138490
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Entity Type | Individual
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Provider Name | MADELINE BAUER
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Gender | Female
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Dates
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Enumeration Date | 05/13/2026
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Last Update Date | 05/13/2026
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Provider Practice Location Address
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Address Line | 336 MAIN ST
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City | WRAY
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State | CO
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Zip | 80758-1707
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Country | US
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Telephone | 970-332-4817
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Fax |
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Provider Business Mailing Address
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Address Line | 29920 COUNTY ROAD 35
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City | WRAY
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State | CO
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Zip | 80758-9363
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Country | US
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Telephone | 605-228-4692
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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 | 00206609
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License Number State | CO
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