MEDICARE: MADELINE PAIGE CONNICK-BALDWIN DDS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	122300000X	Dentist	00203641	CO

General Provider Information

NPI Number	:	1013402916
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MADELINE PAIGE CONNICK-BALDWIN DDS

Provider Business Mailing Address
First Line	:	501 ANGLERS DR STE 102
Second Line	:
City	:	STEAMBOAT SPRINGS
State	:	CO
Zip	:	80487-8841
Country	:	US
Telephone Number	:	970-879-2290
Fax Number	:

Provider Business Practice Location Address
First Line	:	501 ANGLERS DR STE 102
Second Line	:
City	:	STEAMBOAT SPRINGS
State	:	CO
Zip	:	80487-8841
Country	:	US
Telephone Number	:	970-879-2290
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/25/2018
Last Update Date	:	06/25/2018

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