Organization
DORSEY W.BAKER D.D.S. PLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DORSEY W BAKER D.D.S. (MEMBER)
(602) 942-0623
Entity
Organization
Contact information
Practice address
18275 N 59TH AVE, STE 150, GLENDALE, AZ 85308-1260
(602) 942-0623
(602) 942-2409
Mailing address
18275 N 59TH AVE, STE 150, GLENDALE, AZ 85308-1260
(602) 942-0623
(602) 942-2409
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
3760
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3760
ARIZONA DENTAL LICENSE
AZ
Enumeration date
12/12/2006
Last updated
05/29/2009
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