Organization
LARRY L BAKER, MD, DDS, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LARRY L BAKER M.D. (PRESIDENT)
(402) 463-3088
Entity
Organization
Contact information
Practice address
501 W 9TH ST, HASTINGS, NE 68901-3908
(402) 463-3088
(402) 463-3099
Mailing address
PO BOX 947, HASTINGS, NE 68902-0947
(402) 463-3088
(402) 463-3099
Taxonomy
Speciality
Code
Description
License number
State
204E00000X
Oral & Maxillofacial Surgery (D.M.D.)
Primary
22775
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
10025150000
—
NE
Enumeration date
11/26/2007
Last updated
11/26/2007
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