Individual
BAILEY MCKENNA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
14100 58TH ST N, CLEARWATER, FL 33760-9900
(727) 824-8181
Mailing address
14100 58TH ST N, CLEARWATER, FL 33760-9900
(727) 824-8181
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DN29490
FL
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
06/27/2023
Last updated
08/05/2024
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