| Bagley Dental | |
|
1028 W Nixon St Pasco WA 99301-5216 | |
| (509) 547-1632 | |
| (509) 547-6932 |
| Full Name | Bagley Dental |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 1028 W Nixon St, Pasco, Washington |
| Authorized Official Name and Position | James Kent Bagley (DENTAL PROVIDER) |
| Authorized Official Contact | 5095471632 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Bagley Dental 1028 W Nixon St Pasco WA 99301-5216 Ph: (509) 547-1632 | Bagley Dental 1028 W Nixon St Pasco WA 99301-5216 Ph: (509) 547-1632 |
| NPI Number | 1902032899 |
|---|---|
| Provider Enumeration Date | 06/05/2009 |
| Last Update Date | 06/05/2009 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1902032899 | NPI | - | NPPES |
| 5050414 | Medicaid | WA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | DE 3657 (Washington) | Primary |
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