Provider Demographics
NPI:1912022039
Name:MICHAEL O. BAIRD D.D.S., P.C.
Entity Type:Organization
Organization Name:MICHAEL O. BAIRD D.D.S., P.C.
Other - Org Name:OUR FAMILY DENTIST-DEWEY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:ORRIN
Authorized Official - Last Name:BAIRD
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:928-632-8333
Mailing Address - Street 1:150 S STATE ROUTE 69
Mailing Address - Street 2:SUITE 5F
Mailing Address - City:DEWEY
Mailing Address - State:AZ
Mailing Address - Zip Code:86327-9502
Mailing Address - Country:US
Mailing Address - Phone:928-632-8333
Mailing Address - Fax:928-632-5537
Practice Address - Street 1:150 S STATE ROUTE 69
Practice Address - Street 2:SUITE 5F
Practice Address - City:DEWEY
Practice Address - State:AZ
Practice Address - Zip Code:86327-9502
Practice Address - Country:US
Practice Address - Phone:928-632-8333
Practice Address - Fax:928-632-5537
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-20
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZD66451223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty