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General NPI Number Information
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NPI Number | 1528707098
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Entity Type | Individual
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Provider Name | BAYLIE JANE CARROLL DDS
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Gender | Female
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Dates
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Enumeration Date | 06/02/2022
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Last Update Date | 06/02/2022
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Provider Practice Location Address
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Address Line | 346 FORT ZUMWALT SQ
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City | O FALLON
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State | MO
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Zip | 63366-3065
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Country | US
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Telephone | 636-978-6400
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Fax |
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Provider Business Mailing Address
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Address Line | 724 E HIGHWAY U
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City | TROY
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State | MO
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Zip | 63379-3404
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Country | US
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Telephone | 636-358-7041
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Fax |
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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 | 2022018977
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License Number State | MO
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