Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0700X | Prosthodontist | 21163 | TX |
NPI | 1154530574 |
---|---|
Provider Name | Dr. Todd Michael Baumann |
First Address | Dallas, TX 75225-5943 |
Second Address | Dallas, TX 75225-5943 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/05/2007 |
Last Update Date | 25/09/2014 |