Organization
PATRICK M BAUER DDS MS PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. PATRICK M BAUER D.D.S., M.S. (DR)
(417) 883-3740
Entity
Organization
Contact information
Practice address
1250 E WALNUT LAWN ST, SPRINGFIELD, MO 65804-4202
(417) 883-3740
(417) 883-8148
Mailing address
1250 E WALNUT LAWN, SPRINGFIELD, MO 65804-4202
(417) 883-3740
(417) 883-8148
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
05188
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01588
STATE LICENSE
MO
Enumeration date
01/11/2007
Last updated
08/22/2020
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