# BAYLOR COLLEGE OF DENTISTRY

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

## Provider details

- **NPI number:** 1346671245
- **Authorized official:** DR. CHARLES WAKEFIELD DDS (DIRECTOR OF AEGD CLINIC)
- **Authorized official phone:** (214) 828-8213

## Contact information

- **Practice address:** 3302 GASTON AVE, DALLAS, TX 75246-2013
- **Practice address phone:** (214) 828-8213
- **Mailing address:** 3302 GASTON AVE, DALLAS, TX 75246-2013
- **Mailing address phone:** (214) 828-8213

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 122300000X | Dentist | 29122 | TX | Yes |

## Other

- **Enumeration date:** 12/03/2013
- **Last updated:** 12/03/2013