Individual
DR. DAVID RUSSELL BAER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
2041 PEPPER LANE, STE A, PUEBLO, CO 81005
(719) 696-9009
(719) 924-9493
Mailing address
2041 PEPPER LANE, STE A, PUEBLO, CO 81005
(719) 696-9009
(719) 924-9493
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
9645
CO
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
2643
OH
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
DEN00009645
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1992902423
—
CO
Enumeration date
06/28/2007
Last updated
01/03/2023
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