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Contact Information

KENNETH R BAUMGARTNER, DDS
18175 N HIGHWAY ONE
FORT BRAGG, CA95437
 Phone: 707-964-0440
 Fax: 707-964-8373
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

General Practice

1223G0001X
Indicates primary specialty

NPI Profile & details for KENNETH R BAUMGARTNER · (Male)

NPI Number 1205933926
Status Active
Credentials DDS (Doctor of Dental Surgery)
Entity Individual
Enumeration date 09/17/2006
Last updated 07/08/2007 - About 19 years ago
Sole proprietor 1 No
Identifiers
  • CA License # 34056
  • CA Medicaid B34056
  • Other DS034056 BCBS
  • Other 825575 UNITED CONCORDIA
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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