Healthcare Provider Details

I. General information

NPI: 1922154046
Provider Name (Legal Business Name): ROBIN L. BAILEY R.D.H.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/25/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

340 MAGNOLIA CIR
PANAMA CITY FL
32403-5604
US

IV. Provider business mailing address

1203 E 7TH ST
PANAMA CITY FL
32401-4227
US

V. Phone/Fax

Practice location:
  • Phone: 850-283-7574
  • Fax:
Mailing address:
  • Phone: 850-522-5046
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code124Q00000X
TaxonomyDental Hygienist
License NumberDH9854
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: