Provider Demographics
NPI:1093981664
Name:BAUGHMAN, JOSEPH E (DDS)
Entity Type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:E
Last Name:BAUGHMAN
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 1:3455 LAWRENCEVILLE HWY
Mailing Address - Street 2:
Mailing Address - City:LAWRENCEVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30044-4101
Mailing Address - Country:US
Mailing Address - Phone:770-921-1115
Mailing Address - Fax:770-564-3856
Practice Address - Street 1:3455 LAWRENCEVILLE HWY
Practice Address - Street 2:
Practice Address - City:LAWRENCEVILLE
Practice Address - State:GA
Practice Address - Zip Code:30044-4101
Practice Address - Country:US
Practice Address - Phone:770-921-1115
Practice Address - Fax:770-564-3856
Is Sole Proprietor?:No
Enumeration Date:2008-05-05
Last Update Date:2008-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GADN0083241223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice