Thomas Benjamin Baggett III, D.D.S.

Individual provider Active NPI General Practice Dentistry · Branson West, MO

NPI 1376797514 · NPPES record last updated Nov 14, 2008

Key facts

NPI
1376797514
Entity type
Individual (NPI type 1)
Primary specialty
General Practice Dentistry 1223G0001X
License
2007019210 (MO)
Practice address
89 Notch Shopping Center Lane
Suite C
Branson West, MO 65737
Phone
(417) 338-4772
Fax
(417) 338-4774
NPI assigned
Nov 14, 2008
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
2007019210MOMDGeneral Practice Dentistry

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 2007019210 MO Yes

Addresses

Primary practice location

89 Notch Shopping Center Lane
Suite C
Branson West, MO 65737

Mailing address

89 Notch Shopping Center Lane
Suite C
Branson West, MO 65737
Phone (417) 338-4772

Other providers in Branson West, MO

All providers in Branson West, MO · General Practice Dentistry in Missouri

Sources for this page

Verify at the official NPI Registry.