| Elvis Baquero Dds, Inc. | |
|
100826 Nipton Rd Nipton CA 92364 | |
| (760) 856-1056 | |
| (760) 856-1050 |
| Full Name | Elvis Baquero Dds, Inc. |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 100826 Nipton Rd, Nipton, California |
| Authorized Official Name and Position | Elvis Baquero (PRESIDENT) |
| Authorized Official Contact | 7608561056 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Elvis Baquero Dds, Inc. Hc 1 Box 300 Nipton CA 92364-9735 Ph: (760) 856-1056 | Elvis Baquero Dds, Inc. 100826 Nipton Rd Nipton CA 92364 Ph: (760) 856-1056 |
| NPI Number | 1306181037 |
|---|---|
| Provider Enumeration Date | 12/06/2012 |
| Last Update Date | 12/06/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1306181037 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 49059 (California) | Primary |