Individual
DR. KENTON LEE BAILEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
506 W SOUTH ST, MONROEVILLE, IN 46773-9592
(260) 623-6171
Mailing address
506 W SOUTH ST, PO BOX 419, MONROEVILLE, IN 46773-9592
(260) 623-6171
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
12009002A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100082140A
—
IN
Enumeration date
04/19/2006
Last updated
04/09/2013
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