| George W Baker Jr | |
|
606 S Greenwood St Lagrange GA 30240-3128 | |
| (706) 882-5551 | |
| (706) 812-8558 |
| Full Name | George W Baker Jr |
|---|---|
| Speciality | Dentist |
| Location | 606 S Greenwood St, Lagrange, Georgia |
| Authorized Official Name and Position | George W Baker (OWNER) |
| Authorized Official Contact | 7068825551 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| George W Baker Jr Po Box 2030 Lagrange GA 30241-0042 Ph: (706) 882-5551 | George W Baker Jr 606 S Greenwood St Lagrange GA 30240-3128 Ph: (706) 882-5551 |
| NPI Number | 1487807434 |
|---|---|
| Provider Enumeration Date | 11/03/2008 |
| Last Update Date | 12/28/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1487807434 | NPI | - | NPPES |
| 1669413993 | Medicaid | GA | |
| 1386680734 | Medicaid | GA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 8745 (Georgia) | Primary |
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