Baer, David Russell
Baer, David Russell is an sole proprietor health care provider with primary practice located at 2041 Pepper Lane Ste A, Pueblo CO 81005. He recently has 2 registered licenses in different health care specialties including Dental Providers / Oral and Maxillofacial Surgery, Dental Providers / Dentist. Dental Providers / Dentist is his primary health care specialty. Baer, David Russell can be contacted via phone (719) 696-9009.Contact Information
Primary practice address
2041 Pepper Lane Ste A
Pueblo CO 81005
Phone: (719) 696-9009
Fax: (719) 924-9493
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / Oral and Maxillofacial Surgery | 1223S0112X | 2643 | Ohio |
| Dental Providers / Oral and Maxillofacial Surgery | 1223S0112X | DEN00009645 | Colorado |
| Dental Providers / Dentist | 122300000X | 9645 | Colorado |
Profile Details
| NPI number | 1992902423 |
|---|---|
| LBN Legal business name | Baer, David Russell |
| Credentials | Doctor of Dental Surgery (DDS) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jun 28th, 2007 |
| Last updated | Jan 3rd, 2023 - about last year |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1992902423 | NPPES |
| Colorado | MEDICAID | 1992902423 |
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