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Individual

RAYMOND C BAKER JR

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DDS

Contact information

Practice address
1922 THOMSON DRIVE, LYNCHBURG, VA 24501
(434) 845-1121
(434) 845-1096
Mailing address
1922 THOMSON DRIVE, LYNCHBURG, VA 24501
(434) 845-1121
(434) 845-1096

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
0401004767
VA
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
0438000105
VA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
00882
UNITED CONCORDIA
01
179327
ANTHEM BCBS
01
9177705
DORAL
Enumeration date
02/20/2008
Last updated
02/20/2008
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