Individual
DR. HEATHER ILYCIA BAUMHARDT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
052841
NY
1223P0221X
Pediatric Dentistry
Primary
DS037803
PA
Other
Enumeration date
11/12/2008
Last updated
06/25/2009
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