Provider Demographics
NPI:1144649393
Name:BAILEY, THOMAS (DMD)
Entity type:Individual
Prefix:
First Name:THOMAS
Middle Name:
Last Name:BAILEY
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3000 STANSBERRY LN STE 101
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN
Mailing Address - State:TN
Mailing Address - Zip Code:37069-5125
Mailing Address - Country:US
Mailing Address - Phone:615-591-0919
Mailing Address - Fax:502-896-6714
Practice Address - Street 1:3000 STANSBERRY LN STE 101
Practice Address - Street 2:
Practice Address - City:FRANKLIN
Practice Address - State:TN
Practice Address - Zip Code:37069-5125
Practice Address - Country:US
Practice Address - Phone:615-591-0919
Practice Address - Fax:615-599-6762
Is Sole Proprietor?:No
Enumeration Date:2014-04-15
Last Update Date:2020-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TND111451223S0112X
KY10063204E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery
No204E00000XAllopathic & Osteopathic PhysiciansOral & Maxillofacial Surgery