Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 122300000X | Dentist | 30023005 | OH |
NPI | 1003045865 |
---|---|
Provider Name | Emily J. Baker-Damron |
First Address | Pickerington, OH 43147-7994 |
Second Address | Pickerington, OH 43147-7994 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/07/2009 |
Last Update Date | 24/06/2013 |