Individual
DR. DARREL A BAKER
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
2800 PIERCE ST, SUITE 202, SIOUX CITY, IA 51104-3407
(712) 255-0107
(712) 255-0145
Mailing address
2800 PIERCE ST, SUITE 202, SIOUX CITY, IA 51104-3407
(712) 255-0107
(712) 255-0145
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
6049
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0045112
—
IA
01
—
25225
BCBS
IA
05
—
7850270
—
SD
05
—
91201365400
—
NE
Enumeration date
03/21/2006
Last updated
07/08/2007
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