Individual
DR. JOHN C BAINES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
2500 W WILLIAM CANNON DR, SUITE 701, AUSTIN, TX 78745-5257
(512) 892-6200
(512) 892-6277
Mailing address
2500 W WILLIAM CANNON DR, STE 701, AUSTIN, TX 78745-5290
(512) 892-6200
(512) 892-6277
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
15693
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
15693
TEXAS DENTAL LICENSE
TX
01
—
810632639
FEDERAL TAX ID
TX
Enumeration date
10/18/2006
Last updated
01/26/2016
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