Provider Demographics
NPI:1033328612
Name:BAIRD, STANLEY P (DDS)
Entity Type:Individual
Prefix:
First Name:STANLEY
Middle Name:P
Last Name:BAIRD
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11420 S CIENEGA PARK PL
Mailing Address - Street 2:
Mailing Address - City:VAIL
Mailing Address - State:AZ
Mailing Address - Zip Code:85641-8815
Mailing Address - Country:US
Mailing Address - Phone:520-572-4670
Mailing Address - Fax:
Practice Address - Street 1:1370 N SILVERBELL RD STE 190
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85745-2292
Practice Address - Country:US
Practice Address - Phone:520-628-4222
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ51901223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice