Provider Demographics
NPI:1568088219
Name:DANIEL M. BAKER, D.D.S PLLC
Entity Type:Organization
Organization Name:DANIEL M. BAKER, D.D.S PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:MORGAN
Authorized Official - Last Name:BAKER
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:770-910-5230
Mailing Address - Street 1:5905 OLD RICHMOND AVE
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23226-2412
Mailing Address - Country:US
Mailing Address - Phone:770-910-5230
Mailing Address - Fax:
Practice Address - Street 1:104 N MAIN ST
Practice Address - Street 2:
Practice Address - City:HOPEWELL
Practice Address - State:VA
Practice Address - Zip Code:23860-2719
Practice Address - Country:US
Practice Address - Phone:770-910-5230
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-06-18
Last Update Date:2020-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental