Organization
BRENT G BAILEY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KIMBERLY ANN WIGGINS (OFFICE MANAGER)
(843) 886-6461
Entity
Organization
Contact information
Practice address
15 21ST AVE, ISLE OF PALMS, SC 29451-2384
(843) 886-3957
Mailing address
15 21ST AVE, ISLE OF PALMS, SC 29451-2384
(843) 886-3957
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
SC
Other
Enumeration date
05/21/2008
Last updated
05/21/2008
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