Provider Demographics
NPI:1700061496
Name:BAKER, KAREN RAE SHUE (RDH)
Entity Type:Individual
Prefix:MRS
First Name:KAREN RAE
Middle Name:SHUE
Last Name:BAKER
Suffix:
Gender:F
Credentials:RDH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:424 RIVERSIDE DR
Mailing Address - Street 2:SUITE 200
Mailing Address - City:BATTLE CREEK
Mailing Address - State:MI
Mailing Address - Zip Code:49015-3440
Mailing Address - Country:US
Mailing Address - Phone:269-964-7113
Mailing Address - Fax:269-964-6813
Practice Address - Street 1:424 RIVERSIDE DR
Practice Address - Street 2:SUITE 200
Practice Address - City:BATTLE CREEK
Practice Address - State:MI
Practice Address - Zip Code:49015-3440
Practice Address - Country:US
Practice Address - Phone:269-964-7113
Practice Address - Fax:269-964-6813
Is Sole Proprietor?:No
Enumeration Date:2008-01-01
Last Update Date:2008-01-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2902003245124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist