Provider Demographics
NPI:1689983413
Name:AMELIA HAFFNER BAUGH, DDS, PA
Entity Type:Organization
Organization Name:AMELIA HAFFNER BAUGH, DDS, PA
Other - Org Name:AVONDALE HASLET DENTAL CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DENTIST/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:AMELIA
Authorized Official - Middle Name:HAFFNER
Authorized Official - Last Name:BAUGH
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:817-296-1741
Mailing Address - Street 1:1373 AVONDALE HASLET RD.
Mailing Address - Street 2:
Mailing Address - City:HASLET
Mailing Address - State:TX
Mailing Address - Zip Code:76052
Mailing Address - Country:US
Mailing Address - Phone:817-296-1741
Mailing Address - Fax:
Practice Address - Street 1:1373 AVONDALE HASLET RD.
Practice Address - Street 2:
Practice Address - City:HASLET
Practice Address - State:TX
Practice Address - Zip Code:76052
Practice Address - Country:US
Practice Address - Phone:817-296-1741
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-09-28
Last Update Date:2010-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX24024261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental