NPI 1053496083

Dwight Douglas Baker, DDSMS

Practitioner Orthodontics and Dentofacial Orthopedics Dentistry Idaho Falls, ID

Practice location

Address: 1900 John Adams Pkwy, Idaho Falls, ID 83401-4366
Phone: (208) 524-0644
Fax: (208) 524-6100

Registered specialties

Orthodontics and Dentofacial Orthopedics Dentistry Primary

Dental Providers Taxonomy 1223X0400X Licence D-1911-OR (ID)

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Registry record

NPI: 1053496083
Entity type: Individual
Sex (as registered): Male
NPI issued: 26 Oct 2006
Record last updated: 8 Jul 2007

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.