Provider Demographics
NPI:1679900542
Name:ERIC M BAUGHER DMD, PC
Entity Type:Organization
Organization Name:ERIC M BAUGHER DMD, PC
Other - Org Name:CENTRAL VIRGINIA ORTHODONTICS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ERIC
Authorized Official - Middle Name:MICHAEL
Authorized Official - Last Name:BAUGHER
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:434-385-4746
Mailing Address - Street 1:7802 TIMBERLAKE RD
Mailing Address - Street 2:
Mailing Address - City:LYNCHBURG
Mailing Address - State:VA
Mailing Address - Zip Code:24502-2602
Mailing Address - Country:US
Mailing Address - Phone:434-385-4746
Mailing Address - Fax:
Practice Address - Street 1:7802 TIMBERLAKE RD
Practice Address - Street 2:
Practice Address - City:LYNCHBURG
Practice Address - State:VA
Practice Address - Zip Code:24502-2602
Practice Address - Country:US
Practice Address - Phone:434-385-4746
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-10-08
Last Update Date:2013-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA04014142061223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Single Specialty