Provider Demographics
NPI:1053327429
Name:BAIAMONTE, THOMAS D (DMD, MS)
Entity Type:Individual
Prefix:
First Name:THOMAS
Middle Name:D
Last Name:BAIAMONTE
Suffix:
Gender:M
Credentials:DMD, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8401 OSUNA RD NE
Mailing Address - Street 2:SUITE C
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87111-2074
Mailing Address - Country:US
Mailing Address - Phone:505-294-8869
Mailing Address - Fax:505-292-2071
Practice Address - Street 1:8401 OSUNA RD NE
Practice Address - Street 2:SUITE C
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87111-2074
Practice Address - Country:US
Practice Address - Phone:505-294-8869
Practice Address - Fax:505-292-2071
Is Sole Proprietor?:No
Enumeration Date:2006-07-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NM16001223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice