Provider Demographics
NPI:1205043650
Name:BAILEYS & SUTHERLAND DENTAL CORPORATION
Entity Type:Organization
Organization Name:BAILEYS & SUTHERLAND DENTAL CORPORATION
Other - Org Name:EAST COUNTY DENTAL ASSOCIATES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:J
Authorized Official - Last Name:BAILEYS
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:619-444-3127
Mailing Address - Street 1:700 N. JOHNSON AVE SUITE P
Mailing Address - Street 2:
Mailing Address - City:EL CAJON
Mailing Address - State:CA
Mailing Address - Zip Code:92020
Mailing Address - Country:US
Mailing Address - Phone:619-444-3127
Mailing Address - Fax:619-444-3138
Practice Address - Street 1:700 N JOHNSON AVE STE P
Practice Address - Street 2:
Practice Address - City:EL CAJON
Practice Address - State:CA
Practice Address - Zip Code:92020-2589
Practice Address - Country:US
Practice Address - Phone:619-444-3127
Practice Address - Fax:619-444-3138
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-16
Last Update Date:2008-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA31198122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Multi-Specialty