Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0700X | Prosthodontist | 03103 | RI |
N | 1223P0700X | Prosthodontist | 46552 | CA |
NPI | 1083625669 |
---|---|
Provider Name | Dr. Victoria Baeger Daffner |
First Address | Leeds, MA 01053-9764 |
Second Address | Leeds, MA 01053-9764 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/08/2006 |
Last Update Date | 02/12/2020 |