Individual
LARRY L BAKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D., D.D.S.
Contact information
Practice address
501 W 9TH ST, HASTINGS, NE 68901-3908
(402) 463-3088
(402) 463-3099
Mailing address
PO BOX 947, HASTINGS, NE 68902-0947
(402) 463-3088
(402) 463-3099
Taxonomy
Speciality
Code
Description
License number
State
204E00000X
Oral & Maxillofacial Surgery (D.M.D.)
Primary
22775
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
10025150000
—
NE
Enumeration date
09/25/2006
Last updated
07/08/2007
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