Provider Demographics
NPI:1326025461
Name:BAYS, DALE R (MD DDS)
Entity Type:Individual
Prefix:
First Name:DALE
Middle Name:R
Last Name:BAYS
Suffix:
Gender:M
Credentials:MD DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:620 W 32ND ST STE A
Mailing Address - Street 2:
Mailing Address - City:JOPLIN
Mailing Address - State:MO
Mailing Address - Zip Code:64804-2528
Mailing Address - Country:US
Mailing Address - Phone:417-621-0500
Mailing Address - Fax:417-781-5809
Practice Address - Street 1:620 W 32ND ST STE A
Practice Address - Street 2:
Practice Address - City:JOPLIN
Practice Address - State:MO
Practice Address - Zip Code:64804-2528
Practice Address - Country:US
Practice Address - Phone:417-621-0500
Practice Address - Fax:417-781-5809
Is Sole Proprietor?:No
Enumeration Date:2005-12-29
Last Update Date:2021-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MND112701223S0112X
KS615701223S0112X
MO20190107041223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN700229700Medicaid
G92377Medicare UPIN
MN700229700Medicaid