Provider Demographics
NPI:1891898011
Name:BAUMAN, ANDREW JOHN (DDS)
Entity Type:Individual
Prefix:DR
First Name:ANDREW
Middle Name:JOHN
Last Name:BAUMAN
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 1:1355 S FRONTAGE RD
Mailing Address - Street 2:SUITE 330
Mailing Address - City:HASTINGS
Mailing Address - State:MN
Mailing Address - Zip Code:55033-2482
Mailing Address - Country:US
Mailing Address - Phone:651-480-8000
Mailing Address - Fax:
Practice Address - Street 1:1355 S FRONTAGE RD
Practice Address - Street 2:SUITE 330
Practice Address - City:HASTINGS
Practice Address - State:MN
Practice Address - Zip Code:55033-2482
Practice Address - Country:US
Practice Address - Phone:651-480-8000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MND10988122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist