Provider Demographics
NPI:1851788053
Name:BAKER, SUZANNE DAVIS (DDS, MPH)
Entity Type:Individual
Prefix:
First Name:SUZANNE
Middle Name:DAVIS
Last Name:BAKER
Suffix:
Gender:F
Credentials:DDS, MPH
Other - Prefix:
Other - First Name:SUZANNE
Other - Middle Name:LOUISE
Other - Last Name:DAVIS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DDS
Mailing Address - Street 1:2800 WAKEFIELD PINES DRIVE
Mailing Address - Street 2:SUITE 110
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27614
Mailing Address - Country:US
Mailing Address - Phone:919-570-0180
Mailing Address - Fax:919-570-0280
Practice Address - Street 1:510 GLENWOOD AVE
Practice Address - Street 2:SUITE 110
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27603
Practice Address - Country:US
Practice Address - Phone:919-570-0180
Practice Address - Fax:919-570-0280
Is Sole Proprietor?:Yes
Enumeration Date:2015-04-25
Last Update Date:2019-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC10053122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist