# BAGLEY DENTAL

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** BAGLEY DENTAL, PS
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1902032899
- **Legal business name:** BAGLEY DENTAL, PS
- **Authorized official:** DR. JAMES KENT BAGLEY D.D.S. (DENTAL PROVIDER)
- **Authorized official phone:** (509) 547-1632

## Contact information

- **Practice address:** 1028 W NIXON ST, PASCO, WA 99301-5216
- **Practice address phone:** (509) 547-1632
- **Practice address fax:** (509) 547-6932
- **Mailing address:** 1028 W NIXON ST, PASCO, WA 99301-5216
- **Mailing address phone:** (509) 547-1632
- **Mailing address fax:** (509) 547-6932

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | DE 3657 | WA | Yes |

## Other

- **Enumeration date:** 06/05/2009
- **Last updated:** 06/05/2009

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 5050414 | — | WA |