Organization
BAGLEY DENTAL
Active
Parent organization
BAGLEY DENTAL, PS
Organization subpart
Yes
Provider details
NPI number
Legal business name
BAGLEY DENTAL, PS
Authorized official
DR. JAMES KENT BAGLEY D.D.S. (DENTAL PROVIDER)
(509) 547-1632
Entity
Organization
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
06/05/2009
Last updated
06/05/2009
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