Provider Demographics
NPI:1447691035
Name:BALDWIN DENTAL P.C.
Entity type:Organization
Organization Name:BALDWIN DENTAL P.C.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:KEVIN
Authorized Official - Middle Name:
Authorized Official - Last Name:BALDWIN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:702-360-3030
Mailing Address - Street 1:8670 W CHEYENNE AVE STE 205
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89129-7457
Mailing Address - Country:US
Mailing Address - Phone:702-360-3030
Mailing Address - Fax:702-360-2340
Practice Address - Street 1:8670 W CHEYENNE AVE STE 205
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89129-7457
Practice Address - Country:US
Practice Address - Phone:702-360-3030
Practice Address - Fax:702-360-2340
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-07-11
Last Update Date:2013-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV6402261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental