Provider Demographics
NPI:1851917660
Name:OBRIEN, BAILEY (DDS)
Entity Type:Individual
Prefix:
First Name:BAILEY
Middle Name:
Last Name:OBRIEN
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7364 244TH ST
Mailing Address - Street 2:
Mailing Address - City:CASCADE
Mailing Address - State:IA
Mailing Address - Zip Code:52033-8624
Mailing Address - Country:US
Mailing Address - Phone:563-599-0494
Mailing Address - Fax:
Practice Address - Street 1:714 1ST AVE E
Practice Address - Street 2:
Practice Address - City:CASCADE
Practice Address - State:IA
Practice Address - Zip Code:52033-9799
Practice Address - Country:US
Practice Address - Phone:563-852-7390
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-06-18
Last Update Date:2020-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IADDS-09772122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist