Provider Demographics
NPI:1720292238
Name:BAIRD, BRUCE BIRLOND (DDS, FAGD)
Entity Type:Individual
Prefix:DR
First Name:BRUCE
Middle Name:BIRLOND
Last Name:BAIRD
Suffix:
Gender:M
Credentials:DDS, FAGD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1309 PALUXY RD
Mailing Address - Street 2:
Mailing Address - City:GRANBURY
Mailing Address - State:TX
Mailing Address - Zip Code:76048-5663
Mailing Address - Country:US
Mailing Address - Phone:817-573-3761
Mailing Address - Fax:817-573-3764
Practice Address - Street 1:1309 PALUXY RD
Practice Address - Street 2:
Practice Address - City:GRANBURY
Practice Address - State:TX
Practice Address - Zip Code:76048-5663
Practice Address - Country:US
Practice Address - Phone:817-573-3761
Practice Address - Fax:817-573-3764
Is Sole Proprietor?:No
Enumeration Date:2007-05-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX12404122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist