Provider Demographics
NPI:1073536579
Name:BAILEY, TAMARA LYNN (DDS)
Entity Type:Individual
Prefix:DR
First Name:TAMARA
Middle Name:LYNN
Last Name:BAILEY
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2809 SCHOFIELD AVE
Mailing Address - Street 2:SUITE B
Mailing Address - City:SCHOFIELD
Mailing Address - State:WI
Mailing Address - Zip Code:54476-2460
Mailing Address - Country:US
Mailing Address - Phone:715-241-7980
Mailing Address - Fax:715-241-7984
Practice Address - Street 1:2809 SCHOFIELD AVE
Practice Address - Street 2:SUITE B
Practice Address - City:SCHOFIELD
Practice Address - State:WI
Practice Address - Zip Code:54476-2460
Practice Address - Country:US
Practice Address - Phone:715-241-7980
Practice Address - Fax:715-241-7984
Is Sole Proprietor?:No
Enumeration Date:2006-07-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI5785-0151223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice