Individual
JACK DAVITT BALDWIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
4520 CENTERVILLE RD, SAINT PAUL, MN 55127-3602
(651) 426-4799
(651) 426-8106
Mailing address
4520 CENTERVILLE RD, SAINT PAUL, MN 55127-3602
(651) 426-4799
(651) 426-8106
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
12586
MN
Other
Enumeration date
07/31/2008
Last updated
07/31/2008
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