# JACOB M BAGLEY

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Other names:** Bagley Family Dentistry
- **Organization subpart:** No

## Provider details

- **NPI number:** 1154674232
- **Authorized official:** JACOB M BAGLEY DDS (DENTIST / OWNER)
- **Authorized official phone:** (856) 358-2626

## Contact information

- **Practice address:** 508 FRONT ST, ELMER, NJ 08318-2178
- **Practice address phone:** (856) 358-2626
- **Mailing address:** 508 FRONT ST, ELMER, NJ 08318-2178
- **Mailing address phone:** (856) 358-2626

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 122300000X | Dentist | — | — | Yes |
| 332BC3200X | Customized Equipment (DME) | — | — | — |

## Other

- **Enumeration date:** 10/26/2012
- **Last updated:** 08/23/2019