Provider Demographics
NPI:1639472806
Name:MARK A. BAIRD D.D.S. INC
Entity Type:Organization
Organization Name:MARK A. BAIRD D.D.S. INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MARK
Authorized Official - Middle Name:A
Authorized Official - Last Name:BAIRD
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:808-822-9393
Mailing Address - Street 1:4-976 KUHIO HWY
Mailing Address - Street 2:
Mailing Address - City:KAPAA
Mailing Address - State:HI
Mailing Address - Zip Code:96746-1572
Mailing Address - Country:US
Mailing Address - Phone:808-822-9393
Mailing Address - Fax:808-822-7993
Practice Address - Street 1:4-976 KUHIO HWY
Practice Address - Street 2:
Practice Address - City:KAPAA
Practice Address - State:HI
Practice Address - Zip Code:96746-1572
Practice Address - Country:US
Practice Address - Phone:808-822-9393
Practice Address - Fax:808-822-7993
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-12-09
Last Update Date:2010-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HITD-10911223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty