Organization
RYAN B BAKER DMD A PROFESSIONAL DENTAL CORPORATION
Active
Other names
BAKER PEDIATRIC DENTAL CARE
Organization subpart
No
Provider details
NPI number
Authorized official
RYAN B BAKER DMD (OWNDER)
(858) 405-8434
Entity
Organization
Contact information
Practice address
27180 NEWPORT RD STE 3, MENIFEE, CA 92584-7389
(951) 672-1666
(855) 895-3627
Mailing address
14591 NEWPORT AVE STE 108, TUSTIN, CA 92780-6026
(949) 771-7381
(855) 895-3627
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
—
—
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1922465053
NPI
CA
01
—
64066
DENTAL LICENSE
CA
Enumeration date
01/30/2020
Last updated
01/30/2020
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