Individual
JAMES R TAGONI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
DN22298
FL
204E00000X
Oral & Maxillofacial Surgery (D.M.D.)
A141168
CA
204E00000X
Oral & Maxillofacial Surgery (D.M.D.)
DL-10923
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
DDS-09834
STATE LICENSE
IA
Enumeration date
06/22/2010
Last updated
01/27/2021
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