Provider Demographics
NPI:1801862966
Name:BAILEY, WINSTON A (DDS)
Entity Type:Individual
Prefix:DR
First Name:WINSTON
Middle Name:A
Last Name:BAILEY
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:PO BOX 327
Mailing Address - Street 2:116 VICTORIA ST
Mailing Address - City:HALE
Mailing Address - State:MI
Mailing Address - Zip Code:48739-0327
Mailing Address - Country:US
Mailing Address - Phone:989-728-7311
Mailing Address - Fax:989-728-2148
Practice Address - Street 1:116 VICTORIA ST
Practice Address - Street 2:
Practice Address - City:HALE
Practice Address - State:MI
Practice Address - Zip Code:48739
Practice Address - Country:US
Practice Address - Phone:989-728-7311
Practice Address - Fax:989-728-2148
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-02-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI103881223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice