Provider Demographics
NPI:1609426717
Name:BAUGUS, DAKOTA ALAN (DDS)
Entity type:Individual
Prefix:DR
First Name:DAKOTA
Middle Name:ALAN
Last Name:BAUGUS
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 1:235 SW ELM ST
Mailing Address - Street 2:
Mailing Address - City:PULLMAN
Mailing Address - State:WA
Mailing Address - Zip Code:99163-2922
Mailing Address - Country:US
Mailing Address - Phone:580-743-6849
Mailing Address - Fax:
Practice Address - Street 1:1410 SE BISHOP BLVD
Practice Address - Street 2:
Practice Address - City:PULLMAN
Practice Address - State:WA
Practice Address - Zip Code:99163-5419
Practice Address - Country:US
Practice Address - Phone:509-339-6511
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-09-19
Last Update Date:2019-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADE60993139122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist