Provider Demographics
NPI:1295953354
Name:BAUGH ORTHODONTICS
Entity type:Organization
Organization Name:BAUGH ORTHODONTICS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ORTHODONTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:KENT
Authorized Official - Middle Name:J
Authorized Official - Last Name:BAUGH
Authorized Official - Suffix:
Authorized Official - Credentials:DMD, PC
Authorized Official - Phone:801-266-0061
Mailing Address - Street 1:164 E 5900 S
Mailing Address - Street 2:STE A-109
Mailing Address - City:MURRAY
Mailing Address - State:UT
Mailing Address - Zip Code:84107-7256
Mailing Address - Country:US
Mailing Address - Phone:801-266-0061
Mailing Address - Fax:
Practice Address - Street 1:164 E 5900 S
Practice Address - Street 2:STE A-109
Practice Address - City:MURRAY
Practice Address - State:UT
Practice Address - Zip Code:84107-7256
Practice Address - Country:US
Practice Address - Phone:801-266-0061
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-23
Last Update Date:2009-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT140981-9921261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental