Individual
BAILEY MOORHEAD BEARDSLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
USA MEDDAC, 11050 MOUNT BELVEDERE BLVD, FORT DRUM, NY 13602
(315) 772-8891
Mailing address
USA MEDDAC, 11050 MOUNT BELVEDERE BLVD, APO, AA 13602
(315) 772-8891
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
DS041939
PA
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
DS041939
PA
Other
Enumeration date
08/29/2018
Last updated
08/29/2023
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