Bagby, Mark Roy
Bagby, Mark Roy is an individual health care provider with primary practice located at 2935 Bagnell Dam Blvd Ste 112 , Lake Ozark MO 65049-8661. He recently has only one registered license in Dental Providers / General Practice, which is considered as his primary health care specialty. Bagby, Mark Roy can be contacted via phone (578) 349-9578.Contact Information
Primary practice address
2935 Bagnell Dam Blvd Ste 112
Lake Ozark MO 65049-8661
Phone: (578) 349-9578
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / General Practice | 1223G0001X | 15287 | Missouri |
Profile Details
| NPI number | 1477755775 |
|---|---|
| LBN Legal business name | Bagby, Mark Roy |
| Credentials | Doctor of Dental Surgery (DDS) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | May 31st, 2007 |
| Last updated | Feb 8th, 2024 - about 2 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1477755775 | NPPES |
| Missouri | MEDICAID | 403024805 |
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