Individual
DR. KENNETH ANTHONY BAILEY JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
345 N MART PLZ, JACKSON, MS 39206-5316
(601) 981-1000
(601) 981-9440
Mailing address
345 N MART PLZ, JACKSON, MS 39206-5316
(601) 981-1000
(601) 981-9440
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
2815-94
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00660151
—
MS
Enumeration date
08/30/2006
Last updated
07/08/2007
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