Jacob M Bagley

NPI #1154674232 in Elmer, New Jersey

Provider Information

NPI Number: 1154674232
Entity Type: Organization
Organization Name: Jacob M Bagley
Primary Specialty: Dentist
Enumeration Date: Oct 26, 2012
Last Updated: Aug 23, 2019

Practice Location

Address: 508 FRONT ST
City: Elmer
State: New Jersey
ZIP Code: 08318-2178
Phone: (856) 358-2626

Authorized Official

Name: JACOB M BAGLEY, DDS
Title: DENTIST / OWNER
Phone: (856) 358-2626

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Durable Medical Equipment & Medical Supplies - Customized Equipment — Customized Equipment	332BC3200X
Dentist	122300000X	Primary

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