Provider Demographics
NPI:1326092966
Name:BAUER, GEORGE J (DDS)
Entity type:Individual
Prefix:DR
First Name:GEORGE
Middle Name:J
Last Name:BAUER
Suffix:
Gender:
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:688 EISENHOWER BLVD
Mailing Address - Street 2:
Mailing Address - City:JOHNSTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:15904-4303
Mailing Address - Country:US
Mailing Address - Phone:814-266-6820
Mailing Address - Fax:
Practice Address - Street 1:626 WATER ST STE 2
Practice Address - Street 2:
Practice Address - City:ORBISONIA
Practice Address - State:PA
Practice Address - Zip Code:17243-9432
Practice Address - Country:US
Practice Address - Phone:814-447-3159
Practice Address - Fax:814-447-3195
Is Sole Proprietor?:No
Enumeration Date:2006-05-19
Last Update Date:2025-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS021264L122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0005398530002OtherSTATE MEDICAL ASSISTANCE
PABA098629OtherPA BLUE CROSS BLUE SHIELD