Provider Demographics
NPI:1861966954
Name:JAMES S BAUER DMD INCORPORATED
Entity type:Organization
Organization Name:JAMES S BAUER DMD INCORPORATED
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:SAAR
Authorized Official - Last Name:BAUER
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:203-263-4402
Mailing Address - Street 1:40 MAIN ST N STE E
Mailing Address - Street 2:
Mailing Address - City:WOODBURY
Mailing Address - State:CT
Mailing Address - Zip Code:06798-2966
Mailing Address - Country:US
Mailing Address - Phone:203-263-4402
Mailing Address - Fax:203-263-6211
Practice Address - Street 1:40 MAIN ST N STE E
Practice Address - Street 2:
Practice Address - City:WOODBURY
Practice Address - State:CT
Practice Address - Zip Code:06798-2966
Practice Address - Country:US
Practice Address - Phone:203-263-4402
Practice Address - Fax:203-263-6211
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-01-11
Last Update Date:2019-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental