Provider Demographics
NPI:1861645111
Name:BAYLESS, JOHN MARK (DMD)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:MARK
Last Name:BAYLESS
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
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Mailing Address - Street 1:333 EL DORADO ST
Mailing Address - Street 2:
Mailing Address - City:MONTEREY
Mailing Address - State:CA
Mailing Address - Zip Code:93940-4606
Mailing Address - Country:US
Mailing Address - Phone:831-375-9232
Mailing Address - Fax:831-372-0485
Practice Address - Street 1:333 EL DORADO ST
Practice Address - Street 2:
Practice Address - City:MONTEREY
Practice Address - State:CA
Practice Address - Zip Code:93940-4606
Practice Address - Country:US
Practice Address - Phone:831-375-9232
Practice Address - Fax:831-372-0485
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-30
Last Update Date:2008-10-30
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CA0315641223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry