Individual
THERESA BALDWIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS, MA, MS
Contact information
Practice address
1821 S SAN JACINTO AVE STE D, SAN JACINTO, CA 92583-5608
(951) 654-7744
Mailing address
13483 MESA TERRACE DR, YUCAIPA, CA 92399-5800
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
101096
CA
Other
Enumeration date
09/24/2018
Last updated
09/24/2018
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