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Individual

JAMES R TAGONI

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DMD

Contact information

Practice address
835 3RD AVE SE, CEDAR RAPIDS, IA 52403-2407
(319) 366-8277
(319) 366-7091
Mailing address
901 TOWER TERRACE RD, MARION, IA 52302-8975
(319) 366-8277

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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