Provider Demographics
NPI:1821419797
Name:ASHLY BAILEY DDS PLC
Entity Type:Organization
Organization Name:ASHLY BAILEY DDS PLC
Other - Org Name:KATHLEEN KLONOWSKI DDS & ASHLY BAILEYDDS PLC
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ASHLY
Authorized Official - Middle Name:
Authorized Official - Last Name:BAILEY
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:608-338-7705
Mailing Address - Street 1:4685 E MCLEOD DR
Mailing Address - Street 2:
Mailing Address - City:SAGINAW
Mailing Address - State:MI
Mailing Address - Zip Code:48604
Mailing Address - Country:US
Mailing Address - Phone:989-799-5690
Mailing Address - Fax:989-799-5900
Practice Address - Street 1:4685 E MCLEOD DR
Practice Address - Street 2:
Practice Address - City:SAGINAW
Practice Address - State:MI
Practice Address - Zip Code:48604
Practice Address - Country:US
Practice Address - Phone:989-799-5690
Practice Address - Fax:989-799-5900
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-12-19
Last Update Date:2023-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental