Organization
BAYLOR COLLEGE OF DENTISTRY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CHARLES WAKEFIELD DDS (DIRECTOR OF AEGD CLINIC)
(214) 828-8213
Entity
Organization
Contact information
Practice address
3302 GASTON AVE, DALLAS, TX 75246-2013
(214) 828-8213
Mailing address
3302 GASTON AVE, DALLAS, TX 75246-2013
(214) 828-8213
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
29122
TX
Other
Enumeration date
12/03/2013
Last updated
12/03/2013
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