George James Bauries II, DMD

Individual provider Active NPI General Practice Dentistry · Rome, NY

NPI 1275726705 · NPPES record last updated Apr 3, 2012

Key facts

NPI
1275726705
Entity type
Individual (NPI type 1)
Primary specialty
General Practice Dentistry 1223G0001X
License
043909-1 (NY)
Practice address
800 Black River Blvd.
Rome, NY 13440
Phone
(315) 533-6690
NPI assigned
Aug 17, 2007
Sex
Male
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
043909-1NYMDPharmacist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 043909-1 NY Yes

Addresses

Primary practice location

800 Black River Blvd.
Rome, NY 13440

Mailing address

800 Black River Blvd.
Rome, NY 13440
Phone (315) 533-6690

Other providers in Rome, NY

All providers in Rome, NY · General Practice Dentistry in New York

Sources for this page

Verify at the official NPI Registry.