Provider Demographics
NPI:1467743518
Name:JOSHUA E. BAUM, DMD
Entity Type:Organization
Organization Name:JOSHUA E. BAUM, DMD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FINANCE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:PATTI
Authorized Official - Middle Name:
Authorized Official - Last Name:MCCUSKER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:203-426-5900
Mailing Address - Street 1:23 CHURCH HILL RD
Mailing Address - Street 2:
Mailing Address - City:NEWTOWN
Mailing Address - State:CT
Mailing Address - Zip Code:06470-1612
Mailing Address - Country:US
Mailing Address - Phone:203-426-5900
Mailing Address - Fax:203-426-3126
Practice Address - Street 1:23 CHURCH HILL RD
Practice Address - Street 2:
Practice Address - City:NEWTOWN
Practice Address - State:CT
Practice Address - Zip Code:06470-1612
Practice Address - Country:US
Practice Address - Phone:203-426-5900
Practice Address - Fax:203-426-3126
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-04-25
Last Update Date:2011-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT923001223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Single Specialty