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Organization

DR LISA BAILEY DDS, APDC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. LISA C BAILEY DDS (OWNER)
(225) 644-4976
Entity
Organization

Contact information

Practice address
225 W ASCENSION ST, GONZALES, LA 70737-2803
(225) 644-4976
Mailing address
225 W ASCENSION ST, GONZALES, LA 70737-2803
(225) 644-4976

Taxonomy

Speciality
Code
Description
License number
State
292200000X
Dental Laboratory
Primary
1881163
LA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1023163599
LA
05
1235316217
LA
Enumeration date
02/21/2008
Last updated
02/21/2008
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