Provider Demographics
NPI:1407959075
Name:BAUGUSS, JACK TOWLER (DDS MS)
Entity Type:Individual
Prefix:DR
First Name:JACK
Middle Name:TOWLER
Last Name:BAUGUSS
Suffix:
Gender:M
Credentials:DDS MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:6311 KINGSTON PIKE
Mailing Address - Street 2:6W
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37919
Mailing Address - Country:US
Mailing Address - Phone:865-588-5778
Mailing Address - Fax:865-588-5780
Practice Address - Street 1:6311 KINGSTON PIKE
Practice Address - Street 2:6W
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37919
Practice Address - Country:US
Practice Address - Phone:865-588-5778
Practice Address - Fax:865-588-5780
Is Sole Proprietor?:No
Enumeration Date:2006-09-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNDS00000010941223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics