Individual
JOHN BAKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
76 RT 109, WEST BABYLON, NY 11704
(631) 587-7373
(631) 587-7398
Mailing address
76 RT 109, WEST BABYLON, NY 11704
(631) 587-7373
(631) 587-7398
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
041871
NY
Other
Enumeration date
12/12/2006
Last updated
07/08/2007
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