MEDICARE: DR. DANIEL L NAGLER DMD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223P0300X	Periodontics	17504	FL

General Provider Information

NPI Number	:	1912069113
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DANIEL L NAGLER DMD

Provider Business Mailing Address
First Line	:	4106 N 48TH AVE
Second Line	:
City	:	HOLLYWOOD
State	:	FL
Zip	:	33021-1735
Country	:	US
Telephone Number	:	954-518-0662
Fax Number	:

Provider Business Practice Location Address
First Line	:	1499 W PALMETTO PARK RD
Second Line	:	INTERSTATE PLAZA #302
City	:	BOCA RATON
State	:	FL
Zip	:	33486-3328
Country	:	US
Telephone Number	:	954-518-0662
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/14/2006
Last Update Date	:	07/08/2007

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