George W Baker Jr., DMD
Individual provider Active NPI General Practice Dentistry · Lagrange, GA
NPI 1669413993 · NPPES record last updated Jul 2, 2012
Key facts
- NPI
- 1669413993
- Entity type
- Individual (NPI type 1)
- Primary specialty
- General Practice Dentistry 1223G0001X
- License
- 8745 (GA)
- Practice address
- 606 South Greenwood St
Lagrange, GA 30240-2735 - Phone
- (706) 882-5551
- Fax
- (706) 812-8558
- NPI assigned
- Jun 9, 2006
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 8745 | GA | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Lagrange Family Dental Center | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 8745 | GA | Yes |
Addresses
Primary practice location
606 South Greenwood St
Lagrange, GA 30240-2735
Mailing address
606 South Greenwood St
Lagrange, GA 30240-2735
Phone (706) 882-5551
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 000136848A | Medicaid | GA |
Other providers in Lagrange, GA
- Coney Bae
- Kevin Baerwalde
- Alyssa Bagley
- Cassandra Michelle Bailey
- Michael A. Bakarich
- Balanced Health Consultants, LLC
- Michele Marie Ballister
- Debra Denise Banks
- Rhonda Rena Barber
- Christopher Barfield
All providers in Lagrange, GA · General Practice Dentistry in Georgia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 2, 2012. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.