Individual
ROBERT JORDAN BAXT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
2718 S LAKERIDGE TRL, BOULDER, CO 80302-9373
(303) 447-8756
Mailing address
2718 S LAKERIDGE TRL, BOULDER, CO 80302-9373
(303) 447-8756
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
104204
CO
Other
Enumeration date
08/01/2006
Last updated
07/08/2007
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