Provider Demographics
NPI:1487948741
Name:BAILEY, ERIC J (DDS)
Entity type:Individual
Prefix:DR
First Name:ERIC
Middle Name:J
Last Name:BAILEY
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:3659 TEAYS VALLEY RD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:HURRICANE
Mailing Address - State:WV
Mailing Address - Zip Code:25526-9701
Mailing Address - Country:US
Mailing Address - Phone:304-533-6697
Mailing Address - Fax:
Practice Address - Street 1:3659 TEAYS VALLEY RD
Practice Address - Street 2:SUITE 100
Practice Address - City:HURRICANE
Practice Address - State:WV
Practice Address - Zip Code:25526-9701
Practice Address - Country:US
Practice Address - Phone:304-201-8500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-06-04
Last Update Date:2014-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV39511223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry