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Individual

DR. BRIAN EDWIN BAILEY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
D.M.D.

Contact information

Practice address
13011 S 104TH AVE, SUITE # 209, PALOS PARK, IL 60464-1506
(708) 974-0278
Mailing address
13011 S 104TH AVE, SUITE # 209, PALOS PARK, IL 60464-1506
(708) 974-0278

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
019.027383
IL

Other

Enumeration date
11/16/2010
Last updated
02/07/2015
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