Bagley Dental

NPI #1407030984 in Bagley, Minnesota

Provider Information

NPI Number: 1407030984
Entity Type: Organization
Organization Name: Bagley Dental
Primary Specialty: Dentist
Enumeration Date: Dec 20, 2007
Last Updated: Dec 20, 2007

Practice Location

Address: 13 MAIN AVE N
City: Bagley
State: Minnesota
ZIP Code: 56621-0299
Phone: (218) 964-6571

Authorized Official

Name: ROXANE LYNN WAGGONER
Title: OFFICE MANAGER
Phone: (218) 694-6571

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist	122300000X	Primary

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