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Individual

CRAIG JARED BAKER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
DMD

Contact information

Practice address
13501 ICOT BLVD, SUITE 101, CLEARWATER, FL 33760-3729
(727) 531-4462
(727) 210-1754
Mailing address
13501 ICOT BLVD, SUITE 101, CLEARWATER, FL 33760-3729
(727) 531-4462
(727) 210-1754

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DN17163
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
076027700
FL
Enumeration date
01/11/2006
Last updated
02/24/2009
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