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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