Provider Demographics
NPI:1407012032
Name:BAYWOOD DENTAL GROUP
Entity Type:Organization
Organization Name:BAYWOOD DENTAL GROUP
Other - Org Name:BAYWOOD DENTAL GROUP
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:LUZ
Authorized Official - Middle Name:
Authorized Official - Last Name:TORRES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:661-291-1200
Mailing Address - Street 1:24121 BAYWOOD LANE
Mailing Address - Street 2:SUITE A
Mailing Address - City:VALENCIA
Mailing Address - State:CA
Mailing Address - Zip Code:91355-6114
Mailing Address - Country:US
Mailing Address - Phone:661-291-1200
Mailing Address - Fax:661-291-1266
Practice Address - Street 1:24121 BAYWOOD LN
Practice Address - Street 2:SUITE A
Practice Address - City:VALENCIA
Practice Address - State:CA
Practice Address - Zip Code:91355-6114
Practice Address - Country:US
Practice Address - Phone:661-291-1200
Practice Address - Fax:661-291-1266
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-08-04
Last Update Date:2008-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Multi-Specialty