Provider Demographics
NPI:1316267420
Name:DR. CHARLES F. BAKER DMD INC.
Entity type:Organization
Organization Name:DR. CHARLES F. BAKER DMD INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:F
Authorized Official - Last Name:BAKER
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:937-322-9652
Mailing Address - Street 1:144 W PLEASANT ST
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:OH
Mailing Address - Zip Code:45506-2206
Mailing Address - Country:US
Mailing Address - Phone:937-322-9652
Mailing Address - Fax:937-322-5227
Practice Address - Street 1:144 W PLEASANT ST
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:OH
Practice Address - Zip Code:45506-2206
Practice Address - Country:US
Practice Address - Phone:937-322-9652
Practice Address - Fax:937-322-5227
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-06-11
Last Update Date:2010-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH0193731223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty