Provider Demographics
NPI:1912023326
Name:BAILEY, CHAD L (DDS)
Entity Type:Individual
Prefix:DR
First Name:CHAD
Middle Name:L
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 1:341 LOGAN ST
Mailing Address - Street 2:SUITE 110
Mailing Address - City:NOBLESVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:46060-1557
Mailing Address - Country:US
Mailing Address - Phone:317-773-0010
Mailing Address - Fax:317-774-8711
Practice Address - Street 1:341 LOGAN ST
Practice Address - Street 2:SUITE 110
Practice Address - City:NOBLESVILLE
Practice Address - State:IN
Practice Address - Zip Code:46060-1557
Practice Address - Country:US
Practice Address - Phone:317-773-0010
Practice Address - Fax:317-774-8711
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN12010136122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist