Kenneth Roger Baumgartner, DDS Valid NPI
Individual provider · General Practice Dentistry · Fort Bragg, CA
- NPI
- 1205933926
- Type
- Individual (Type 1)
- Primary specialty
- General Practice Dentistry (Dentist)
- Specialty group
- Dental Providers
- Taxonomy code
- 1223G0001X
- License number
- 34056 (CA)
- Sex
- Male
- Sole proprietor
- No
- Enumerated
- 2006-09-17
- Last updated
- 2007-07-08
Practice location
18175 N Highway One
Fort Bragg, CA 95437
(707) 964-0440