Provider Demographics
NPI:1740498765
Name:BAILEY, THOMAS TOCK (DDS)
Entity type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:TOCK
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 1:950 W. AVON
Mailing Address - Street 2:STE. 1
Mailing Address - City:ROCHESTER HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48307
Mailing Address - Country:US
Mailing Address - Phone:248-656-2300
Mailing Address - Fax:248-656-3574
Practice Address - Street 1:950 W AVON RD
Practice Address - Street 2:STE. 1
Practice Address - City:ROCHESTER HILLS
Practice Address - State:MI
Practice Address - Zip Code:48307-2761
Practice Address - Country:US
Practice Address - Phone:248-656-2300
Practice Address - Fax:248-656-3574
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI09821122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist