Provider Demographics
NPI:1851950026
Name:BALDRIDGE, ERIN LEIGH
Entity Type:Individual
Prefix:DR
First Name:ERIN
Middle Name:LEIGH
Last Name:BALDRIDGE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:62 EMORY WAY
Mailing Address - Street 2:
Mailing Address - City:HAMPTON
Mailing Address - State:VA
Mailing Address - Zip Code:23666-4360
Mailing Address - Country:US
Mailing Address - Phone:308-520-3453
Mailing Address - Fax:
Practice Address - Street 1:JOINT BASE LANGLEY EUSTIS DENTAL CLINIC
Practice Address - Street 2:76 NEALY AVE
Practice Address - City:APO
Practice Address - State:AA
Practice Address - Zip Code:23665
Practice Address - Country:US
Practice Address - Phone:757-225-7630
Practice Address - Fax:757-225-0595
Is Sole Proprietor?:No
Enumeration Date:2019-06-11
Last Update Date:2019-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE7536122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist