Individual
MICHAEL R BAILEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D., D.D.S.
Contact information
Practice address
403 SOUTH 11TH STREET, SUITE 300, BOISE, ID 83702-6906
(208) 344-9115
(208) 344-9113
Mailing address
403 SOUTH 11TH STREET, SUITE 300, BOISE, ID 83702-6906
(208) 344-9115
(208) 344-9113
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
D3165
ID
Other
Enumeration date
07/06/2006
Last updated
01/23/2012
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