Provider Demographics
NPI:1093273922
Name:JOEL BAEZ, D.M.D, P.A
Entity Type:Organization
Organization Name:JOEL BAEZ, D.M.D, P.A
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JOEL
Authorized Official - Middle Name:
Authorized Official - Last Name:BAEZ
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:561-276-6684
Mailing Address - Street 1:160 SE 6TH AVE STE B-1
Mailing Address - Street 2:
Mailing Address - City:DELRAY BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33483-5264
Mailing Address - Country:US
Mailing Address - Phone:561-276-6684
Mailing Address - Fax:
Practice Address - Street 1:160 SE 6TH AVE STE B-1
Practice Address - Street 2:
Practice Address - City:DELRAY BEACH
Practice Address - State:FL
Practice Address - Zip Code:33483-5264
Practice Address - Country:US
Practice Address - Phone:561-276-6684
Practice Address - Fax:561-276-6685
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-03-10
Last Update Date:2019-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty
No1223P0300XDental ProvidersDentistPeriodonticsGroup - Multi-Specialty