Provider Demographics
NPI:1669140836
Name:DGB PLLC
Entity type:Organization
Organization Name:DGB PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DROSTAN
Authorized Official - Middle Name:GREGG
Authorized Official - Last Name:BAKER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:509-565-8803
Mailing Address - Street 1:23208 E COLONY CT
Mailing Address - Street 2:
Mailing Address - City:LIBERTY LAKE
Mailing Address - State:WA
Mailing Address - Zip Code:99019-8525
Mailing Address - Country:US
Mailing Address - Phone:208-757-1618
Mailing Address - Fax:509-842-3057
Practice Address - Street 1:2207 N MOLTER RD STE 203
Practice Address - Street 2:
Practice Address - City:LIBERTY LAKE
Practice Address - State:WA
Practice Address - Zip Code:99019-7571
Practice Address - Country:US
Practice Address - Phone:509-565-8803
Practice Address - Fax:509-842-3057
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-09-02
Last Update Date:2021-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty