Provider Demographics
NPI:1881629285
Name:BAKER, JAMIE C (DDS)
Entity Type:Individual
Prefix:
First Name:JAMIE
Middle Name:C
Last Name:BAKER
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2735 WESTINGHOUSE RD
Mailing Address - Street 2:
Mailing Address - City:HORSEHEADS
Mailing Address - State:NY
Mailing Address - Zip Code:14845-8100
Mailing Address - Country:US
Mailing Address - Phone:607-739-2150
Mailing Address - Fax:607-795-1791
Practice Address - Street 1:2735 WESTINGHOUSE RD
Practice Address - Street 2:
Practice Address - City:HORSEHEADS
Practice Address - State:NY
Practice Address - Zip Code:14845-8100
Practice Address - Country:US
Practice Address - Phone:607-739-2150
Practice Address - Fax:607-795-1791
Is Sole Proprietor?:No
Enumeration Date:2006-07-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY048419122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist