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Organization
ELVIS BAQUERO DDS, INC.
Active
Organization
ELVIS BAQUERO DDS, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ELVIS BAQUERO DDS (PRESIDENT)
(760) 856-1056
Entity
Organization
Contact information
Practice address
100826 NIPTON RD, NIPTON, CA 92364
(760) 856-1056
(760) 856-1050
Mailing address
HC 1 BOX 300, NIPTON, CA 92364-9735
(760) 856-1056
(760) 856-1050
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
49059
CA
Other
Enumeration date
12/06/2012
Last updated
12/06/2012
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