| Bagley Dental | |
|
13 Main Ave N Bagley MN 56621-0299 | |
| (218) 964-6571 | |
| (218) 694-6555 |
| Full Name | Bagley Dental |
|---|---|
| Speciality | Dentist |
| Location | 13 Main Ave N, Bagley, Minnesota |
| Authorized Official Name and Position | Roxane Lynn Waggoner (OFFICE MANAGER) |
| Authorized Official Contact | 2186946571 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Bagley Dental Po Box 299 Bagley MN 56621-0299 Ph: (218) 964-6571 | Bagley Dental 13 Main Ave N Bagley MN 56621-0299 Ph: (218) 964-6571 |
| NPI Number | 1407030984 |
|---|---|
| Provider Enumeration Date | 12/20/2007 |
| Last Update Date | 12/20/2007 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1407030984 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 10967 (Minnesota) | Secondary |
| 122300000X | Dentist | 10965 (Minnesota) | Primary |
| 122300000X | Dentist | 10792 (Minnesota) | Secondary |
Mississippi Headwaters Area Dental Health Center, Inc. Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 13 Main Ave N, Bagley, MN 56621 Phone: 218-694-6571 |