| Organization Name: | MATTHEW W. BAYLESS DDS PC |
| NPI Number: | 1093118259 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | MATTHEW W. BAYLESS (DENTIST/OWNER) |
| Mailing Address: | 19750 State Highway 46 W Suite 105 Spring Branch |
| State: | TX US |
| Postal Code: | 780706880 |
| Phone Number: | 8304382193 |
| Fax Number: | 8304382196 |
| NPI Enumeration Date: | 10/02/2014 |
| NPI Last Update Date: | 10/02/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QD0000X |
| License Number: | 22467 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | TX |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Dental |
| Taxonomy Definition: | |