Organization
SAMUEL BROUGHTON BAKER JR
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MIRIAM E BAKER (OFFICE MANAGER)
(803) 793-3653
Entity
Organization
Contact information
Practice address
174 BEECH AVENUE, DENMARK, SC 29042-0158
(803) 793-3653
Mailing address
PO BOX 158, DENMARK, SC 29042-0158
(803) 793-3653
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
1912
SC
Other
Enumeration date
09/24/2009
Last updated
09/24/2009
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