Basic Information
| Provider Information | |||||||||
| NPI: | 1447345798 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | BAYDOUN | ||||||||
| FirstName: | WAEL | ||||||||
| MiddleName: | MOHAMAD | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | D.D.S. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1185 US HIGHWAY 23 N | ||||||||
| Address2: | |||||||||
| City: | ALPENA | ||||||||
| State: | MI | ||||||||
| PostalCode: | 497078018 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9893583946 | ||||||||
| FaxNumber: | 9893583724 | ||||||||
| Practice Location | |||||||||
| Address1: | 1185 US HIGHWAY 23 N | ||||||||
| Address2: | |||||||||
| City: | ALPENA | ||||||||
| State: | MI | ||||||||
| PostalCode: | 497078018 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9893583946 | ||||||||
| FaxNumber: | 9893583724 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/04/2006 | ||||||||
| LastUpdateDate: | 01/23/2012 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 1223G0001X | 2901019342 | MI | Y | Dental Providers | Dentist | General Practice |
No ID Information.