Provider Demographics
NPI:1639111800
Name:BAIRD, MICHAEL ORRIN (DDS)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:ORRIN
Last Name:BAIRD
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:150 S HIGHWAY 69
Mailing Address - Street 2:SUITE #5
Mailing Address - City:DEWEY
Mailing Address - State:AZ
Mailing Address - Zip Code:86327-9502
Mailing Address - Country:US
Mailing Address - Phone:928-632-8333
Mailing Address - Fax:928-632-5537
Practice Address - Street 1:150 S HIGHWAY 69
Practice Address - Street 2:SUITE #5
Practice Address - City:DEWEY
Practice Address - State:AZ
Practice Address - Zip Code:86327-9502
Practice Address - Country:US
Practice Address - Phone:928-632-8333
Practice Address - Fax:928-632-5537
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZD66451223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ957516OtherAHCCCS PROVIDER NUMBER