Provider Demographics
NPI:1992765820
Name:BAER, JEFF (DDS)
Entity type:Individual
Prefix:
First Name:JEFF
Middle Name:
Last Name:BAER
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 1:2606 GREEN OAK DR
Mailing Address - Street 2:SUITE C
Mailing Address - City:KINGWOOD
Mailing Address - State:TX
Mailing Address - Zip Code:77339-2490
Mailing Address - Country:US
Mailing Address - Phone:281-359-3636
Mailing Address - Fax:281-359-3680
Practice Address - Street 1:2606 GREEN OAK DR
Practice Address - Street 2:SUITE C
Practice Address - City:KINGWOOD
Practice Address - State:TX
Practice Address - Zip Code:77339-2490
Practice Address - Country:US
Practice Address - Phone:281-359-3636
Practice Address - Fax:281-359-3680
Is Sole Proprietor?:No
Enumeration Date:2006-03-24
Last Update Date:2014-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ79741223E0200X
TX297991223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics