MEDICARE: CHRISTOPHER BAILEY DDS

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
1	122300000X	Dentist	5574	OK

General Provider Information

NPI Number	:	1629014360
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHRISTOPHER BAILEY DDS

Provider Business Mailing Address
First Line	:	6165 N MAY AVE
Second Line	:	SUITE A
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73112-4276
Country	:	US
Telephone Number	:	405-848-4877
Fax Number	:	405-848-4879

Provider Business Practice Location Address
First Line	:	6165 N MAY AVE
Second Line	:	SUITE A
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73112-4276
Country	:	US
Telephone Number	:	405-848-4877
Fax Number	:	405-848-4879

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/21/2006
Last Update Date	:	07/08/2007

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