Individual
KEITH BAINES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
386 CENTRAL AVE., JERSEY CITY, NJ 07307
(201) 659-5030
Mailing address
386 CENTRAL AVENUE, JERSEY CITY, NJ 07307
(201) 659-5030
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DI019809
NJ
Other
Enumeration date
03/27/2007
Last updated
07/08/2007
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