Provider Demographics
NPI:1770557092
Name:BAILEY, DAVID W (DDS)
Entity type:Individual
Prefix:DR
First Name:DAVID
Middle Name:W
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 1:634 PRINCESS DR
Mailing Address - Street 2:
Mailing Address - City:CANTON
Mailing Address - State:MI
Mailing Address - Zip Code:48188-1144
Mailing Address - Country:US
Mailing Address - Phone:734-844-8772
Mailing Address - Fax:
Practice Address - Street 1:20302 EUREKA RD
Practice Address - Street 2:SUITE A
Practice Address - City:TAYLOR
Practice Address - State:MI
Practice Address - Zip Code:48180-5310
Practice Address - Country:US
Practice Address - Phone:734-283-5757
Practice Address - Fax:734-283-5863
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-02-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2901011776122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist