Provider Demographics
NPI:1205366838
Name:ERIC BAKER DDS, MD INC
Entity Type:Organization
Organization Name:ERIC BAKER DDS, MD INC
Other - Org Name:NIGUEL COAST ORAL AND FACIAL SURGERY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ERIC
Authorized Official - Middle Name:CHRISTOPHER
Authorized Official - Last Name:BAKER
Authorized Official - Suffix:
Authorized Official - Credentials:DDS, MD
Authorized Official - Phone:805-338-6454
Mailing Address - Street 1:32241 CROWN VALLEY PKWY STE 220
Mailing Address - Street 2:
Mailing Address - City:DANA POINT
Mailing Address - State:CA
Mailing Address - Zip Code:92629-3310
Mailing Address - Country:US
Mailing Address - Phone:949-240-2280
Mailing Address - Fax:949-240-2619
Practice Address - Street 1:32241 CROWN VALLEY PKWY STE 220
Practice Address - Street 2:
Practice Address - City:DANA POINT
Practice Address - State:CA
Practice Address - Zip Code:92629-3310
Practice Address - Country:US
Practice Address - Phone:949-240-2280
Practice Address - Fax:949-240-2619
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-06-15
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QS0112XAmbulatory Health Care FacilitiesClinic/CenterOral and Maxillofacial Surgery