Healthcare Provider Details

I. General information

NPI: 1295346302
Provider Name (Legal Business Name): BAILEY DENTAL GROUP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/12/2020
Last Update Date: 08/12/2020
Certification Date: 08/12/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

67640 S MAIN ST
RICHMOND MI
48062-1926
US

IV. Provider business mailing address

PO BOX 219
RICHMOND MI
48062-0219
US

V. Phone/Fax

Practice location:
  • Phone: 586-727-7531
  • Fax:
Mailing address:
  • Phone: 586-727-7531
  • Fax: 586-727-4404

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223D0001X
TaxonomyPublic Health Dentistry
License Number
License Number State

VIII. Authorized Official

Name: MICHELLE SCHWEIGER
Title or Position: INSURANCE COORDIANTOR
Credential:
Phone: 586-727-7531