# BAUM DENTAL, PC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1326381112
- **Authorized official:** DONNA MARIE KIRCHNER REDENTIALING MANAGER (CREDENTIALING MANAGER)
- **Authorized official phone:** (586) 873-4483

## Contact information

- **Practice address:** 20720 PLYMOUTH RD, DETROIT, MI 48228-1275
- **Practice address phone:** (313) 342-1997
- **Practice address fax:** (313) 416-1405
- **Mailing address:** 20720 PLYMOUTH RD, DETROIT, MI 48228-1275
- **Mailing address phone:** (313) 342-1997
- **Mailing address fax:** (313) 416-1405

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 122300000X | Dentist | 2901010299 | MI | Yes |

## Other

- **Enumeration date:** 04/01/2013
- **Last updated:** 06/23/2017