Provider Demographics
NPI:1205235900
Name:BAKER, ANDREW JOSEPH (DMD)
Entity type:Individual
Prefix:DR
First Name:ANDREW
Middle Name:JOSEPH
Last Name:BAKER
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:409 POND ST STE 6
Mailing Address - Street 2:
Mailing Address - City:BRAINTREE
Mailing Address - State:MA
Mailing Address - Zip Code:02184-6853
Mailing Address - Country:US
Mailing Address - Phone:781-843-3061
Mailing Address - Fax:
Practice Address - Street 1:409 POND ST STE 6
Practice Address - Street 2:
Practice Address - City:BRAINTREE
Practice Address - State:MA
Practice Address - Zip Code:02184-6853
Practice Address - Country:US
Practice Address - Phone:781-843-3061
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-08-19
Last Update Date:2014-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA18566541223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice