MEDICARE: DR. ASHLY ANN BAILEY D.D.S

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry	2901020187	MI

General Provider Information

NPI Number	:	1558680108
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ASHLY ANN BAILEY D.D.S

Provider Business Mailing Address
First Line	:	1601 MARQUETTE AVE
Second Line	:	SUITE 2
City	:	BAY CITY
State	:	MI
Zip	:	48706
Country	:	US
Telephone Number	:	608-338-7705
Fax Number	:

Provider Business Practice Location Address
First Line	:	1601 MARQUETTE ST
Second Line	:	SUITE 2
City	:	BAY CITY
State	:	MI
Zip	:	48706-4196
Country	:	US
Telephone Number	:	608-338-7705
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/21/2010
Last Update Date	:	05/21/2010

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