Individual
BEN BAKER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1804 BROOK AVE, WICHITA FALLS, TX 76301-5622
(940) 247-0286
Mailing address
1804 BROOK AVE, WICHITA FALLS, TX 76301-5622
(940) 247-0286
Taxonomy
Speciality
Code
Description
License number
State
1223E0200X
Endodontics
Primary
26494
TX
1223E0200X
Endodontics
6806
WI
Other
Enumeration date
05/17/2012
Last updated
09/23/2013
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