Provider Demographics
NPI:1225031198
Name:BAYS, ROGER NELSON (DDS)
Entity Type:Individual
Prefix:DR
First Name:ROGER
Middle Name:NELSON
Last Name:BAYS
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:407 3RD AVE E
Mailing Address - Street 2:
Mailing Address - City:BIG STONE GAP
Mailing Address - State:VA
Mailing Address - Zip Code:24219-2365
Mailing Address - Country:US
Mailing Address - Phone:276-523-0931
Mailing Address - Fax:276-523-0932
Practice Address - Street 1:407 3RD AVE E
Practice Address - Street 2:
Practice Address - City:BIG STONE GAP
Practice Address - State:VA
Practice Address - Zip Code:24219-2365
Practice Address - Country:US
Practice Address - Phone:276-523-0931
Practice Address - Fax:276-523-0932
Is Sole Proprietor?:Yes
Enumeration Date:2005-05-24
Last Update Date:2011-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA04010053201223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice