Provider Demographics
NPI:1821136888
Name:BAKER, TAMMY MARIE (DDS)
Entity Type:Individual
Prefix:
First Name:TAMMY
Middle Name:MARIE
Last Name:BAKER
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3954 CARMELA CT E
Mailing Address - Street 2:
Mailing Address - City:BELLBROOK
Mailing Address - State:OH
Mailing Address - Zip Code:45305-1373
Mailing Address - Country:US
Mailing Address - Phone:937-848-9286
Mailing Address - Fax:
Practice Address - Street 1:547 SPINNING RD
Practice Address - Street 2:
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45431-2157
Practice Address - Country:US
Practice Address - Phone:937-252-1463
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH209431223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice