Individual
JAMES KENT BAGLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
1028 W NIXON ST, PASCO, WA 99301-5216
(509) 547-1632
(509) 547-6932
Mailing address
1028 W NIXON ST, PASCO, WA 99301-5216
(509) 547-1632
(509) 547-6932
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DE 3657
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5050414
—
WA
Enumeration date
03/12/2007
Last updated
07/09/2007
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