Provider Demographics
NPI:1649382391
Name:BAKER, CHASE MATTHEW (DDS)
Entity Type:Individual
Prefix:
First Name:CHASE
Middle Name:MATTHEW
Last Name:BAKER
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 1:3515 ELLA BLVD
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77018-6103
Mailing Address - Country:US
Mailing Address - Phone:713-682-4406
Mailing Address - Fax:
Practice Address - Street 1:3515 ELLA BLVD
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77018-6103
Practice Address - Country:US
Practice Address - Phone:713-682-4406
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2012-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX22846122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist