Provider Demographics
NPI:1083744734
Name:BAULDIE, MERLYN PATRICIA (DDS)
Entity Type:Individual
Prefix:DR
First Name:MERLYN
Middle Name:PATRICIA
Last Name:BAULDIE
Suffix:
Gender:F
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:PO BOX 516
Mailing Address - Street 2:
Mailing Address - City:NAPLES
Mailing Address - State:NY
Mailing Address - Zip Code:14512
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:703 E MAPLE AVE
Practice Address - Street 2:FLDDSO ARTICLE 16 CLINIC
Practice Address - City:NEWARK
Practice Address - State:NY
Practice Address - Zip Code:14513
Practice Address - Country:US
Practice Address - Phone:315-331-1700
Practice Address - Fax:315-331-3946
Is Sole Proprietor?:No
Enumeration Date:2007-03-06
Last Update Date:2007-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0494231122300000X, 1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
No1223G0001XDental ProvidersDentistGeneral Practice