Healthcare Provider Details

I. General information

NPI: 1346243839
Provider Name (Legal Business Name): ROBERT THOMAS BAYLEY III D.M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/27/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1129 WEST CHESTER PIKE
WEST CHESTER PA
19382
US

IV. Provider business mailing address

1129 WEST CHESTER PIKE
WEST CHESTER PA
19382
US

V. Phone/Fax

Practice location:
  • Phone: 610-692-7868
  • Fax: 610-692-3459
Mailing address:
  • Phone: 610-692-7868
  • Fax: 610-692-3459

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License NumberDS019512L
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: