Provider Demographics
NPI:1154530574
Name:BAUMANN, TODD MICHAEL (DDS, MS)
Entity type:Individual
Prefix:DR
First Name:TODD
Middle Name:MICHAEL
Last Name:BAUMANN
Suffix:
Gender:M
Credentials:DDS, MS
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Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:8226 DOUGLAS AVE
Mailing Address - Street 2:SUITE 857
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75225-5943
Mailing Address - Country:US
Mailing Address - Phone:214-363-4488
Mailing Address - Fax:214-363-5151
Practice Address - Street 1:8226 DOUGLAS AVE
Practice Address - Street 2:SUITE 857
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75225-5943
Practice Address - Country:US
Practice Address - Phone:214-363-4488
Practice Address - Fax:214-363-5151
Is Sole Proprietor?:No
Enumeration Date:2007-05-22
Last Update Date:2014-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX211631223P0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0700XDental ProvidersDentistProsthodontics
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX542164407OtherTIN