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Individual

DR. DOMINIQUE ARIEL BALDWIN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
DMD

Contact information

Practice address
80 AUTUMN FERN TRL, LILLINGTON, NC 27546-5155
(910) 814-4191
(910) 814-4198
Mailing address
2122 PEGASUS BAY DR, FUQUAY VARINA, NC 27526-3835
(336) 567-5969

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
12281
NC
390200000X
Student in an Organized Health Care Education/Training Program

Other

Enumeration date
04/17/2021
Last updated
06/18/2021
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