Provider Demographics
NPI:1902965247
Name:BAKER, ARNOLD (DDS, MS)
Entity Type:Individual
Prefix:DR
First Name:ARNOLD
Middle Name:
Last Name:BAKER
Suffix:
Gender:M
Credentials:DDS, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1650 WAUKAZOO DR
Mailing Address - Street 2:
Mailing Address - City:HOLLAND
Mailing Address - State:MI
Mailing Address - Zip Code:49424-2418
Mailing Address - Country:US
Mailing Address - Phone:616-399-0960
Mailing Address - Fax:
Practice Address - Street 1:12662 RILEY ST
Practice Address - Street 2:SUITE 110
Practice Address - City:HOLLAND
Practice Address - State:MI
Practice Address - Zip Code:49424-8023
Practice Address - Country:US
Practice Address - Phone:616-399-3946
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MIMI093941223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice