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General NPI Number Information
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NPI Number | 1609347731
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Entity Type | Organization
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Legal Business Name | THOMAS J BAGLEY D.D.S., P.A.
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Dates
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Enumeration Date | 12/16/2018
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Last Update Date | 12/16/2018
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Provider Practice Location Address
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Address Line | 2729 HORSE PEN CREEK RD STE 103
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City | GREENSBORO
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State | NC
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Zip | 27410-8396
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Country | US
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Telephone | 336-854-5850
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Fax |
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Provider Business Mailing Address
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Address Line | 2729 HORSE PEN CREEK RD STE 103
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City | GREENSBORO
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State | NC
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Zip | 27410-8396
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Country | US
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Telephone | 336-854-5850
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. THOMAS BAGLEY
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Credential | DDS
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Telephone | 336-854-5850
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number |
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License Number State |
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