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NPI Code Detail

MEDICARE: DR. ELYSA BAILEY DEMORAIS D.D.S.

MEDICARE:  DR. ELYSA BAILEY DEMORAIS  D.D.S.
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
1122300000XDentist8492NC

General Provider Information

NPI Number : 1568657492
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. ELYSA BAILEY DEMORAIS D.D.S.
Provider Business Mailing Address
First Line : 900 SUMMIT AVE
Second Line :
City : GREENSBORO
State : NC
Zip : 27405-7918
Country : US
Telephone Number : 336-370-1112
Fax Number : 336-544-0739
Provider Business Practice Location Address
First Line : 900 SUMMIT AVE
Second Line :
City : GREENSBORO
State : NC
Zip : 27405-7918
Country : US
Telephone Number : 336-370-1112
Fax Number : 336-544-0739
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/13/2007
Last Update Date : 09/13/2007

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Directions to “ DR. ELYSA BAILEY DEMORAIS D.D.S.” Practice Location

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