Provider Demographics
NPI:1164986303
Name:BAIG DENTAL PA
Entity Type:Organization
Organization Name:BAIG DENTAL PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:PARVEZ
Authorized Official - Middle Name:
Authorized Official - Last Name:BAIG
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:339-203-5331
Mailing Address - Street 1:189 S HWY 17 92 STE 100
Mailing Address - Street 2:
Mailing Address - City:DEBARY
Mailing Address - State:FL
Mailing Address - Zip Code:32713-1832
Mailing Address - Country:US
Mailing Address - Phone:386-668-2181
Mailing Address - Fax:
Practice Address - Street 1:189 S HWY 17 92 STE 100
Practice Address - Street 2:
Practice Address - City:DEBARY
Practice Address - State:FL
Practice Address - Zip Code:32713-1832
Practice Address - Country:US
Practice Address - Phone:386-668-2181
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-01-22
Last Update Date:2019-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental