Provider Demographics
NPI:1386659787
Name:EMMA REBECCA BAYS CARLON DDS FAGD PC
Entity Type:Organization
Organization Name:EMMA REBECCA BAYS CARLON DDS FAGD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:BECKY
Authorized Official - Middle Name:BAYS
Authorized Official - Last Name:CARLON
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:229-883-1123
Mailing Address - Street 1:1105 W 4TH AVE
Mailing Address - Street 2:
Mailing Address - City:ALBANY
Mailing Address - State:GA
Mailing Address - Zip Code:31707
Mailing Address - Country:US
Mailing Address - Phone:229-883-1123
Mailing Address - Fax:229-883-1104
Practice Address - Street 1:1105 W 4TH AVE
Practice Address - Street 2:
Practice Address - City:ALBANY
Practice Address - State:GA
Practice Address - Zip Code:31707
Practice Address - Country:US
Practice Address - Phone:229-883-1123
Practice Address - Fax:229-883-1104
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-31
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA8720122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty