Provider Demographics
NPI:1972286078
Name:BAXTER, ADRIAN PATRICE
Entity Type:Individual
Prefix:MRS
First Name:ADRIAN
Middle Name:PATRICE
Last Name:BAXTER
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 1:31 MDG
Mailing Address - Street 2:UNIT 6180
Mailing Address - City:APO
Mailing Address - State:AE
Mailing Address - Zip Code:09604-0245
Mailing Address - Country:US
Mailing Address - Phone:314-632-6600
Mailing Address - Fax:
Practice Address - Street 1:31 MDG
Practice Address - Street 2:UNIT 6180
Practice Address - City:APO
Practice Address - State:AE
Practice Address - Zip Code:09604-0245
Practice Address - Country:US
Practice Address - Phone:314-632-6600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-08
Last Update Date:2023-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes126800000XDental ProvidersDental Assistant