Provider Demographics
NPI:1851406722
Name:BAIRD, ROY I JR (DDS)
Entity Type:Individual
Prefix:MR
First Name:ROY
Middle Name:I
Last Name:BAIRD
Suffix:JR
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:2901 W BELTLINE HWY
Mailing Address - Street 2:STE.120
Mailing Address - City:MADISON
Mailing Address - State:WI
Mailing Address - Zip Code:53713-4226
Mailing Address - Country:US
Mailing Address - Phone:608-443-5500
Mailing Address - Fax:608-441-1981
Practice Address - Street 1:3434 E.WASHINGTON AVE.
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:WI
Practice Address - Zip Code:53704-4155
Practice Address - Country:US
Practice Address - Phone:608-443-5550
Practice Address - Fax:608-443-5534
Is Sole Proprietor?:No
Enumeration Date:2006-08-20
Last Update Date:2012-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI2883-151223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI33438000Medicaid