MEDICARE: DR. DANIELLE VOLANTE BAUMAN DMD

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	1223G0001X	General Practice Dentistry	DS0000010975	TN
2	390200000X	Student in an Organized Health Care Education/Training Program	DN015644	GA
3	1223G0001X	General Practice Dentistry	DN015644	GA

General Provider Information

NPI Number	:	1285139915
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DANIELLE VOLANTE BAUMAN DMD

Provider Business Mailing Address
First Line	:	355 COLERAINE PL
Second Line	:
City	:	ROSWELL
State	:	GA
Zip	:	30075-5572
Country	:	US
Telephone Number	:	678-761-3277
Fax Number	:

Provider Business Practice Location Address
First Line	:	3535 ROSWELL RD STE 55
Second Line	:
City	:	MARIETTA
State	:	GA
Zip	:	30062-8828
Country	:	US
Telephone Number	:	770-321-5558
Fax Number	:

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

Provider Enumeration Date	:	03/26/2018
Last Update Date	:	09/30/2022

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