Provider Demographics
NPI:1386713345
Name:BAKER, ROBERT LEE (DMD)
Entity type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:LEE
Last Name:BAKER
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1927 NORTH GILBERT ROAD
Mailing Address - Street 2:SUITE 12
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85203-2851
Mailing Address - Country:US
Mailing Address - Phone:480-461-9944
Mailing Address - Fax:480-461-0497
Practice Address - Street 1:1927 NORTH GILBERT ROAD
Practice Address - Street 2:SUITE 12
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85203-2851
Practice Address - Country:US
Practice Address - Phone:480-461-9944
Practice Address - Fax:480-461-0497
Is Sole Proprietor?:No
Enumeration Date:2006-11-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ3438122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist