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NPI Code Detail

MEDICARE: BAILEY DUFFY DMD

MEDICARE: BAILEY DUFFY DMD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11223P0221XPediatric Dentistry11206.PDSC

General Provider Information

NPI Number : 1558046995
Entity Type Code : Individual
Provider Name (Legal Business Name) : BAILEY DUFFY DMD
Provider Business Mailing Address
First Line : 996 TANNER FORD BLVD
Second Line :
City : HANAHAN
State : SC
Zip : 29410-4780
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 996 TANNER FORD BLVD
Second Line :
City : HANAHAN
State : SC
Zip : 29410-4780
Country : US
Telephone Number : 843-818-5437
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/21/2023
Last Update Date : 12/01/2025

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