Clinton David Baugham, DMD

Individual provider Active NPI General Practice Dentistry · Peachtree Corners, GA

NPI 1295170652 · NPPES record last updated May 20, 2026

Key facts

NPI
1295170652
Entity type
Individual (NPI type 1)
Primary specialty
General Practice Dentistry 1223G0001X
License
DN014793 (GA)
Practice address
3961 Holcomb Bridge Rd Ste 100
Peachtree Corners, GA 30092-5298
Phone
(770) 449-0202
Fax
(770) 502-6772
NPI assigned
Apr 30, 2013
Sex
Male
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
DN014793GAMDGeneral Practice Dentistry

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X DN014793 GA Yes

Addresses

Primary practice location

3961 Holcomb Bridge Rd Ste 100
Peachtree Corners, GA 30092-5298

Mailing address

3961 Holcomb Bridge Rd Ste 100
Peachtree Corners, GA 30092-5298
Phone (770) 449-0202

Other providers in Peachtree Corners, GA

All providers in Peachtree Corners, GA · General Practice Dentistry in Georgia

Sources for this page

Verify at the official NPI Registry.