Organization
BAKER, DEST, BAKER, DDS, PLLC
Active
Other names
Kings Mountain Medicaid Dentistry
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RICHARD F DEST DDS (REGISTERED AGENT/MEMBER)
(704) 547-1279
Entity
Organization
Contact information
Practice address
107 E MOUNTAIN ST, KINGS MOUNTAIN, NC 28086-3442
(704) 739-4473
Mailing address
8305 UNIVERSITY EXEC PARK DR, SUITE 300, CHARLOTTE, NC 28262-1361
(704) 547-1279
(704) 547-8383
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
5283
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
890175T
—
NC
Enumeration date
05/22/2008
Last updated
05/28/2008
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