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General NPI Number Information
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NPI Number | 1518015114
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Entity Type | Organization
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Legal Business Name | L'TANYA J. BAILEY, D.D.S, MS, PLLC
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Dates
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Enumeration Date | 01/08/2007
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Last Update Date | 09/24/2012
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Provider Practice Location Address
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Address Line | 6425 OLD PLANK RD SUITE 108
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City | HIGH POINT
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State | NC
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Zip | 27265-3277
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Country | US
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Telephone | 336-886-7000
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Fax | 336-886-7002
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Provider Business Mailing Address
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Address Line | PO BOX 6074
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City | HIGH POINT
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State | NC
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Zip | 27262-6074
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Country | US
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Telephone | 336-886-7000
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Fax | 336-886-7002
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Authorized Official
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Title or Position | ORTHODONTIST
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Name | DR. L'TANYA JOY BAILEY
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Credential | D.D.S., MS, PLLC
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Telephone | 336-886-7000
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number | 5199
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License Number State | NC
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