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General NPI Number Information
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NPI Number | 1851518799
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Entity Type | Organization
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Legal Business Name | DAVID G. NANGLE
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Dates
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Enumeration Date | 04/20/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 213 NORTH ST
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City | AUBURN
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State | NY
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Zip | 13021-1246
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Country | US
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Telephone | 315-253-4902
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Fax |
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Provider Business Mailing Address
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Address Line | 3853 MANDY RUE
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City | AUBURN
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State | NY
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Zip | 13021-9495
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Country | US
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Telephone | 315-685-1914
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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. DAVID G NANGLE
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Credential | DDS
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Telephone | 315-253-4902
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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 | 038541
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License Number State | NY
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