Provider Demographics
NPI:1336252980
Name:BAILEY, ROBBINS MARK (DDS)
Entity Type:Individual
Prefix:DR
First Name:ROBBINS
Middle Name:MARK
Last Name:BAILEY
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:DR
Other - First Name:ROBBINS
Other - Middle Name:MARK
Other - Last Name:BAILEY
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DDS,PA
Mailing Address - Street 1:2114 RICE STREET
Mailing Address - Street 2:
Mailing Address - City:WALDRON
Mailing Address - State:AR
Mailing Address - Zip Code:72958-0907
Mailing Address - Country:US
Mailing Address - Phone:479-637-2735
Mailing Address - Fax:479-637-5091
Practice Address - Street 1:2114 RICE STREET
Practice Address - Street 2:
Practice Address - City:WALDRON
Practice Address - State:AR
Practice Address - Zip Code:72958-0907
Practice Address - Country:US
Practice Address - Phone:479-637-2735
Practice Address - Fax:479-637-5091
Is Sole Proprietor?:No
Enumeration Date:2006-08-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARAR26251223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice