Provider Demographics
NPI:1871905893
Name:LAPP, BAILEY (RDH)
Entity type:Individual
Prefix:
First Name:BAILEY
Middle Name:
Last Name:LAPP
Suffix:
Gender:F
Credentials:RDH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 173
Mailing Address - Street 2:33337 BOWMAN RD
Mailing Address - City:ECHO
Mailing Address - State:OR
Mailing Address - Zip Code:97826-0173
Mailing Address - Country:US
Mailing Address - Phone:541-377-2440
Mailing Address - Fax:
Practice Address - Street 1:143 N MAIN ST
Practice Address - Street 2:
Practice Address - City:HEPPNER
Practice Address - State:OR
Practice Address - Zip Code:97836-5001
Practice Address - Country:US
Practice Address - Phone:888-468-0022
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-05-25
Last Update Date:2014-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORH6498124Q00000X
WADH60416401124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist