Provider Demographics
NPI:1912080318
Name:BAKER, ALLAN S (DDS)
Entity Type:Individual
Prefix:DR
First Name:ALLAN
Middle Name:S
Last Name:BAKER
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 1:1320 7TH STREET
Mailing Address - Street 2:
Mailing Address - City:SNOHOMISH
Mailing Address - State:WA
Mailing Address - Zip Code:98290-2348
Mailing Address - Country:US
Mailing Address - Phone:360-568-4911
Mailing Address - Fax:360-568-6246
Practice Address - Street 1:1320 7TH STREET
Practice Address - Street 2:
Practice Address - City:SNOHOMISH
Practice Address - State:WA
Practice Address - Zip Code:98290-2348
Practice Address - Country:US
Practice Address - Phone:360-568-4911
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADE000055411223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice