Individual
JAMES ANDREW BAGLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
4904 CONVENTION DR., PASCO, WA 99301
(509) 547-1631
(509) 547-3885
Mailing address
4904 CONVENTION DR., PASCO, WA 99301
(509) 547-1631
(509) 547-3885
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DE7684
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5050422
—
WA
Enumeration date
03/07/2007
Last updated
07/09/2007
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