Healthcare Provider Details

I. General information

NPI: 1538374525
Provider Name (Legal Business Name): DEAN EDWARD DAGERMANGY M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/11/2007
Last Update Date: 02/15/2023
Certification Date: 02/15/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

625 BAKERS BRIDGE AVE STE 105-37
FRANKLIN TN
37067-1613
US

IV. Provider business mailing address

625 BAKERS BRIDGE AVE STE 105-37
FRANKLIN TN
37067-1613
US

V. Phone/Fax

Practice location:
  • Phone: 770-261-4955
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberA94885
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: