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General NPI Number Information
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NPI Number | 1477862076
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Entity Type | Individual
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Provider Name | DAVID G BAILEY D.D.S.
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Gender | Male
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Dates
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Enumeration Date | 09/29/2010
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Last Update Date | 02/10/2020
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Provider Practice Location Address
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Address Line | 531 COFFEEN AVE
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City | SHERIDAN
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State | WY
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Zip | 82801-5311
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Country | US
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Telephone | 307-674-5437
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Fax | 307-655-8311
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Provider Business Mailing Address
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Address Line | 531 COFFEEN AVE
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City | SHERIDAN
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State | WY
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Zip | 82801-5311
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Country | US
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Telephone | 307-674-5437
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Fax | 307-655-8311
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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 | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number | 76935609922
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License Number State | UT
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Taxonomy #2
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Taxonomy Code | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number | 1271
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License Number State | WY
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