Provider Demographics
NPI:1447507256
Name:BAKER, MORGAN KNEIB
Entity type:Individual
Prefix:
First Name:MORGAN
Middle Name:KNEIB
Last Name:BAKER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:MORGAN
Other - Middle Name:D
Other - Last Name:KNEIB
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:516 TRAIL AVE
Mailing Address - Street 2:SUITE B
Mailing Address - City:FREDERICK
Mailing Address - State:MD
Mailing Address - Zip Code:21701-4942
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:516 TRAIL AVE
Practice Address - Street 2:SUITE B
Practice Address - City:FREDERICK
Practice Address - State:MD
Practice Address - Zip Code:21701-4942
Practice Address - Country:US
Practice Address - Phone:240-566-7005
Practice Address - Fax:240-566-7006
Is Sole Proprietor?:Yes
Enumeration Date:2012-08-10
Last Update Date:2019-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD15331122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist