MEDICARE: HOWARD M. BAKER, JR., DDS, PA

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	261QD0000X	Dental Clinic/Center	5200	NC

General Provider Information

NPI Number	:	1306960802
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HOWARD M. BAKER, JR., DDS, PA

Provider Business Mailing Address
First Line	:	617 E WASHINGTON ST
Second Line	:
City	:	NASHVILLE
State	:	NC
Zip	:	27856-1737
Country	:	US
Telephone Number	:	252-459-4406
Fax Number	:	252-459-9351

Provider Business Practice Location Address
First Line	:	617 E WASHINGTON ST
Second Line	:
City	:	NASHVILLE
State	:	NC
Zip	:	27856-1737
Country	:	US
Telephone Number	:	252-459-4406
Fax Number	:	252-459-9351

Authorized Official
Title or Position	:	OWNER
Name	:	DR. HOWARD MELVIN BAKER JR.
Credential	:	D.D.S.
Telephone Number	:	252-459-4406

Provider Enumeration Date	:	03/19/2007
Last Update Date	:	08/22/2020

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