MEDICARE: DR. DAVID ALEXANDER GAGE D.M.D

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	1223G0001X	General Practice Dentistry	DE 60472401	WA

General Provider Information

NPI Number	:	1952719957
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DAVID ALEXANDER GAGE D.M.D

Provider Business Mailing Address
First Line	:	3136 SQUALICUM PKWY STE A
Second Line	:
City	:	BELLINGHAM
State	:	WA
Zip	:	98225-1955
Country	:	US
Telephone Number	:	360-671-5800
Fax Number	:	360-671-5802

Provider Business Practice Location Address
First Line	:	3136 SQUALICUM PKWY STE A
Second Line	:
City	:	BELLINGHAM
State	:	WA
Zip	:	98225-1955
Country	:	US
Telephone Number	:	360-671-5800
Fax Number	:	360-671-5802

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

Provider Enumeration Date	:	07/23/2014
Last Update Date	:	07/23/2014

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