Provider Demographics
NPI:1649623398
Name:BAXTER, ALBERT DONALD (DDS)
Entity type:Individual
Prefix:DR
First Name:ALBERT
Middle Name:DONALD
Last Name:BAXTER
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 1:133 W INGOMAR RD
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15237-4931
Mailing Address - Country:US
Mailing Address - Phone:412-364-9361
Mailing Address - Fax:
Practice Address - Street 1:133 W INGOMAR RD
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15237-4931
Practice Address - Country:US
Practice Address - Phone:412-364-9361
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-07-18
Last Update Date:2016-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS-015851LPA1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice