Individual
DR. DWIGHT DOUGLAS BAKER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S., M.S.
Contact information
Practice address
1900 JOHN ADAMS PKWY, IDAHO FALLS, ID 83401-4366
(208) 524-0644
(208) 524-6100
Mailing address
1900 JOHN ADAMS PKWY, IDAHO FALLS, ID 83401-4366
(208) 524-0644
(208) 524-6100
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
D-1911-OR
ID
Other
Enumeration date
10/26/2006
Last updated
07/08/2007
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