Provider Demographics
NPI:1013402916
Name:CONNICK-BALDWIN, MADELINE PAIGE (DDS)
Entity Type:Individual
Prefix:
First Name:MADELINE
Middle Name:PAIGE
Last Name:CONNICK-BALDWIN
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:MADELINE
Other - Middle Name:
Other - Last Name:CONNICK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DDS
Mailing Address - Street 1:501 ANGLERS DR STE 102
Mailing Address - Street 2:
Mailing Address - City:STEAMBOAT SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80487-8841
Mailing Address - Country:US
Mailing Address - Phone:970-879-2290
Mailing Address - Fax:
Practice Address - Street 1:501 ANGLERS DR STE 102
Practice Address - Street 2:
Practice Address - City:STEAMBOAT SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80487-8841
Practice Address - Country:US
Practice Address - Phone:970-879-2290
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-06-25
Last Update Date:2018-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO00203641122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist