Provider Demographics
NPI:1528374618
Name:BAYLON, NICHOLAS B (DDS)
Entity type:Individual
Prefix:DR
First Name:NICHOLAS
Middle Name:B
Last Name:BAYLON
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Gender:M
Credentials:DDS
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Mailing Address - Street 1:9950 VALLEY CREEK ROAD
Mailing Address - Street 2:SUITE #150
Mailing Address - City:WOODBURY
Mailing Address - State:MN
Mailing Address - Zip Code:55125-4884
Mailing Address - Country:US
Mailing Address - Phone:651-702-1462
Mailing Address - Fax:651-702-3828
Practice Address - Street 1:9950 VALLEY CREEK ROAD
Practice Address - Street 2:SUITE #150
Practice Address - City:WOODBURY
Practice Address - State:MN
Practice Address - Zip Code:55125-4884
Practice Address - Country:US
Practice Address - Phone:651-702-1462
Practice Address - Fax:651-702-3828
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-26
Last Update Date:2015-06-11
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Provider Licenses
StateLicense IDTaxonomies
MND128691223G0001X, 1223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry
No1223G0001XDental ProvidersDentistGeneral Practice