Individual
EMIL BAILEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
555 E FORDHAM RD, BRONX, NY 10458-5046
(347) 801-8888
(347) 801-8888
Mailing address
555 E FORDHAM RD, BRONX, NY 10458-5046
(347) 801-8888
(347) 801-8888
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
055755
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03437749
—
NY
01
—
055755
NY STATE DENTAL LICENSE
NY
01
—
1902157910
GROUP NPI
NY
01
—
455093797
TID
NY
Enumeration date
04/05/2012
Last updated
06/18/2018
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