Provider Demographics
NPI:1962682583
Name:BAIRD, ROBERT MARK (DMD)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:MARK
Last Name:BAIRD
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:1392 TURF FARM WAY
Mailing Address - Street 2:SUITE #1
Mailing Address - City:PAYSON
Mailing Address - State:UT
Mailing Address - Zip Code:84651-6500
Mailing Address - Country:US
Mailing Address - Phone:801-465-4490
Mailing Address - Fax:801-465-4217
Practice Address - Street 1:1392 TURF FARM WAY
Practice Address - Street 2:SUITE #1
Practice Address - City:PAYSON
Practice Address - State:UT
Practice Address - Zip Code:84651-6500
Practice Address - Country:US
Practice Address - Phone:801-465-4490
Practice Address - Fax:801-465-4217
Is Sole Proprietor?:Yes
Enumeration Date:2007-11-12
Last Update Date:2007-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT6466262-9922122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist