Individual
DR. HENRY JOSEPH TAGLE III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.M.D.
Contact information
Practice address
1600 W. UNIVESITY AVE STE 103, SUITE 102, FLAGSTAFF, AZ 86001
(928) 774-4400
(928) 774-5436
Mailing address
1600 W. UNIVESITY AVE STE 103, SUITE 102, FLAGSTAFF, AZ 86001
(928) 774-4400
(928) 774-5436
Taxonomy
Speciality
Code
Description
License number
State
1223E0200X
Endodontics
Primary
6531
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
6531
LICENSE NUMBER
AZ
01
—
860875508
TAX ID
AZ
Enumeration date
02/07/2007
Last updated
01/25/2017
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