MEDICARE: DR. RONALD FRANK BALDO D.D.S.

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	4147	LA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1548273063
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. RONALD FRANK BALDO D.D.S.

Provider Business Mailing Address
First Line	:	36464 MONROE CRAWFORD RD
Second Line	:
City	:	PEARL RIVER
State	:	LA
Zip	:	70452-4212
Country	:	US
Telephone Number	:	985-863-3336
Fax Number	:

Provider Business Practice Location Address
First Line	:	66240 HIGHWAY 41 SPUR
Second Line	:	SUITE B
City	:	PEARL RIVER
State	:	LA
Zip	:	70452-5749
Country	:	US
Telephone Number	:	985-863-6740
Fax Number	:	985-863-0047

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

Provider Enumeration Date	:	08/14/2006
Last Update Date	:	07/08/2007

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