Individual
JAMES ROBERT TAGUE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
138 CHURCH ST, ALEXANDRIA BAY, NY 13607
(315) 482-9941
(315) 482-2783
Mailing address
PO BOX 8, ALEXANDRIA BAY, NY 13607
(315) 482-9941
(315) 482-2783
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
038171
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02407683
—
NY
Enumeration date
07/03/2006
Last updated
07/08/2007
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