| NPI | 1598019325 |
|---|---|
| Former Name | STACY LYNN BAKER |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: MI 2901021156) |
| Additional Taxonomies | 1223P0221X Dentist, Pediatric Dentistry (Licence: IL 319.018288) |
| Enumeration Date | 2012-10-31 |
| Last Update Date | 2014-10-09 |