Melvin O Baker, D.M.D

Individual provider Active NPI General Practice Dentistry · Covington, GA

NPI 1750301602 · NPPES record last updated Jul 8, 2007

Key facts

NPI
1750301602
Entity type
Individual (NPI type 1)
Primary specialty
General Practice Dentistry 1223G0001X
License
8252 (GA)
Practice address
4115 Tate St NE
Covington, GA 30014-2554
Phone
(770) 787-2230
Fax
(770) 787-0508
NPI assigned
Jul 20, 2006
Sex
Male
Sole proprietor
Yes

Medicare participation

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

National Provider Directory

Medicare enrollment (NPD)
No

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 8252 GA Yes

Addresses

Primary practice location

4115 Tate St NE
Covington, GA 30014-2554

Mailing address

4115 Tate Street
Covington, GA 30014
Phone (770) 787-2230

Other identifiers

IdentifierTypeStateIssuer
100365OtherMAAVESIS
9180656OtherWIDORAL

Other providers in Covington, GA

All providers in Covington, GA · General Practice Dentistry in Georgia

Sources for this page

Verify at the official NPI Registry.