Provider Demographics
NPI:1649264433
Name:BAKKE, JOSEPH C (DDS)
Entity type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:C
Last Name:BAKKE
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 1:2923 CHARTER OAK DR
Mailing Address - Street 2:
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72227-3007
Mailing Address - Country:US
Mailing Address - Phone:501-221-7072
Mailing Address - Fax:501-987-7372
Practice Address - Street 1:1090 ARNOLD DR
Practice Address - Street 2:
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:77209
Practice Address - Country:US
Practice Address - Phone:501-987-7323
Practice Address - Fax:501-987-7372
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-09-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR34451223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice