MEDICARE: BRITTANY LAUREN BAIRD

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	126800000X	Dental Assistant

General Provider Information

NPI Number	:	1205468139
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BRITTANY LAUREN BAIRD

Provider Business Mailing Address
First Line	:	5 CASTLE WAY
Second Line	:
City	:	CARSON CITY
State	:	NV
Zip	:	89706-1932
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1789 COLLEGE PKWY STE 121
Second Line	:
City	:	CARSON CITY
State	:	NV
Zip	:	89706-7976
Country	:	US
Telephone Number	:	775-857-9453
Fax Number	:

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

Provider Enumeration Date	:	02/08/2020
Last Update Date	:	02/08/2020

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Directions to “ BRITTANY LAUREN BAIRD ” Practice Location

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