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Organization

MICHAEL R BAILEY MD DDS PA

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MICHAEL R BAILEY MD DDS (OWNER)
(208) 344-9115
Entity
Organization

Contact information

Practice address
403 S 11TH ST, SUITE 300, BOISE, ID 83702-6968
(208) 344-9115
(208) 344-9113
Mailing address
403 S 11TH ST, SUITE 300, BOISE, ID 83702-6968
(208) 344-9115
(208) 344-9113

Taxonomy

Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
D3165/M6325
ID

Other

Enumeration date
04/09/2008
Last updated
01/23/2012
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