Provider Demographics
NPI:1073669321
Name:BAKER, DAVID ARTHUR (DDS)
Entity type:Individual
Prefix:DR
First Name:DAVID
Middle Name:ARTHUR
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 1:4201 BEE CAVE RD
Mailing Address - Street 2:STE. B-210
Mailing Address - City:WEST LAKE HILLS
Mailing Address - State:TX
Mailing Address - Zip Code:78746-6465
Mailing Address - Country:US
Mailing Address - Phone:512-328-0911
Mailing Address - Fax:512-328-3801
Practice Address - Street 1:4201 BEE CAVE RD
Practice Address - Street 2:STE. B-210
Practice Address - City:WEST LAKE HILLS
Practice Address - State:TX
Practice Address - Zip Code:78746-6465
Practice Address - Country:US
Practice Address - Phone:512-328-0911
Practice Address - Fax:512-328-3801
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX155941223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX15594OtherDENTAL LICENSE NUMBER