Healthcare Provider Details
I. General information
NPI: 1235497652
Provider Name (Legal Business Name): NATOSHA BAILEY RDH
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 04/24/2012
Last Update Date: 04/24/2012
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2805 GILBERT AVE
CINCINNATI OH
45206-1210
US
IV. Provider business mailing address
2415 AUBURN AVE
CINCINNATI OH
45219-2701
US
V. Phone/Fax
- Phone: 513-281-4116
- Fax: 513-475-5982
- Phone: 513-221-4949
- Fax: 513-241-4191
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 124Q00000X |
| Taxonomy | Dental Hygienist |
| License Number | 31.009011 |
| License Number State | OH |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: