Individual
DR. AUSTIN BAULDRY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS, MSD
Contact information
Practice address
7095 DOUGLAS BLVD STE A, GRANITE BAY, CA 95746-6299
(916) 677-1216
Mailing address
9401 RAWHIDE LN, ROSEVILLE, CA 95747-9715
(209) 405-1247
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
105140
CA
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
105140
CA
Other
Enumeration date
07/31/2020
Last updated
05/08/2026
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