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General NPI Number Information
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NPI Number | 1053480541
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Entity Type | Individual
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Provider Name | MICHAEL W. BAILEY D.D.S.
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Gender | Male
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Dates
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Enumeration Date | 11/07/2006
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Last Update Date | 07/09/2007
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Provider Practice Location Address
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Address Line | 10211 144TH ST E
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City | PUYALLUP
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State | WA
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Zip | 98374-4955
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Country | US
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Telephone | 253-848-7281
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Fax | 253-841-7935
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Provider Business Mailing Address
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Address Line | 10211 144TH ST E
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City | PUYALLUP
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State | WA
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Zip | 98374-4955
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Country | US
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Telephone | 253-848-7281
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Fax | 253-841-7935
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | DE00004825
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License Number State | WA
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