Provider Demographics
NPI:1407188584
Name:JOHN C BAAR, JR, DDS, LLC
Entity Type:Organization
Organization Name:JOHN C BAAR, JR, DDS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:C
Authorized Official - Last Name:BAAR
Authorized Official - Suffix:JR
Authorized Official - Credentials:DDS
Authorized Official - Phone:301-596-9000
Mailing Address - Street 1:12496 HALL SHOP RD
Mailing Address - Street 2:
Mailing Address - City:FULTON
Mailing Address - State:MD
Mailing Address - Zip Code:20759-9746
Mailing Address - Country:US
Mailing Address - Phone:301-596-9000
Mailing Address - Fax:301-596-9044
Practice Address - Street 1:12496 HALL SHOP RD
Practice Address - Street 2:
Practice Address - City:FULTON
Practice Address - State:MD
Practice Address - Zip Code:20759-9746
Practice Address - Country:US
Practice Address - Phone:301-596-9000
Practice Address - Fax:301-596-9044
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-02-01
Last Update Date:2010-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty