Provider Demographics
NPI:1578789285
Name:D THAD BAIRD D M D P C
Entity Type:Organization
Organization Name:D THAD BAIRD D M D P C
Other - Org Name:BAIRD & BAIRD FAMILY DENTISTRY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:INSURANCE COORDINATOR
Authorized Official - Prefix:
Authorized Official - First Name:ADRIANE
Authorized Official - Middle Name:VOGEL
Authorized Official - Last Name:KELLNER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:770-517-0444
Mailing Address - Street 1:4595 TOWNE LAKE PKWY
Mailing Address - Street 2:BLDG 200, STE 110
Mailing Address - City:WOODSTOCK
Mailing Address - State:GA
Mailing Address - Zip Code:30189-5514
Mailing Address - Country:US
Mailing Address - Phone:770-517-0444
Mailing Address - Fax:770-517-0493
Practice Address - Street 1:4595 TOWNE LAKE PKWY
Practice Address - Street 2:BLDG 200, STE 110
Practice Address - City:WOODSTOCK
Practice Address - State:GA
Practice Address - Zip Code:30189-5514
Practice Address - Country:US
Practice Address - Phone:770-517-0444
Practice Address - Fax:770-517-0493
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-18
Last Update Date:2008-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty