Provider Demographics
NPI:1871714451
Name:BAILEY, EDWARD STEVENSON (DDS)
Entity type:Individual
Prefix:DR
First Name:EDWARD
Middle Name:STEVENSON
Last Name:BAILEY
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 KEYBRIDGE DR
Mailing Address - Street 2:STE D
Mailing Address - City:MORRISVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27560-5917
Mailing Address - Country:US
Mailing Address - Phone:919-678-8787
Mailing Address - Fax:
Practice Address - Street 1:100 KEYBRIDGE DRIVE
Practice Address - Street 2:SUITE D
Practice Address - City:MORRISVILLE
Practice Address - State:NC
Practice Address - Zip Code:27560
Practice Address - Country:US
Practice Address - Phone:919-678-8787
Practice Address - Fax:919-678-0599
Is Sole Proprietor?:No
Enumeration Date:2007-05-01
Last Update Date:2016-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC72481223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice