Provider Demographics
NPI:1073988127
Name:RICHARD P BAKER DDS
Entity Type:Organization
Organization Name:RICHARD P BAKER DDS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:P
Authorized Official - Last Name:BAKER
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:480-985-1910
Mailing Address - Street 1:160 S POWER RD
Mailing Address - Street 2:
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85206-5230
Mailing Address - Country:US
Mailing Address - Phone:480-985-1910
Mailing Address - Fax:480-985-1913
Practice Address - Street 1:160 S POWER RD
Practice Address - Street 2:
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85206-5230
Practice Address - Country:US
Practice Address - Phone:480-985-1910
Practice Address - Fax:480-985-1913
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-12-01
Last Update Date:2015-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty