Mark Laurence Bailen, D.M.D.
Individual provider Active NPI Dentist · East Walpole, MA
NPI 1710104773 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1710104773
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Dentist 122300000X
- License
- 17548 (MA)
- Practice address
- 90 Providence Hwy
Walpole Mall
East Walpole, MA 02032-1524 - Phone
- (508) 668-1151
- Fax
- (508) 668-0640
- NPI assigned
- Apr 19, 2007
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 17548 | MA | MD | Physical Therapist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 17548 | MA | Yes |
Addresses
Primary practice location
90 Providence Hwy
Walpole Mall
East Walpole, MA 02032-1524
Mailing address
74 Billings St
Sharon, MA 02067-2140
Other providers in East Walpole, MA
- Accompany Doula Care, Inc.
- Julianny Michelle Alcantara
- Karen D. Allen
- Arcangel Neurological Consultants, LLC
- Arul PLLC of Walpole
- Nicole Bodenrader
- Nicole Santina Borrelli
- Janet Boudreau
- Kathleen M Bowler
- Joanna Nancy Capparella
All providers in East Walpole, MA · Dentist in Massachusetts
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.