MEDICARE: DR. JAMES PATRICK GAGLIARDI D.D.S.

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	DE00005122	WA

General Provider Information

NPI Number	:	1043281165
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JAMES PATRICK GAGLIARDI D.D.S.

Provider Business Mailing Address
First Line	:	1033 REGENTS BLVD
Second Line	:	SUITE 201
City	:	FIRCREST
State	:	WA
Zip	:	98466-6045
Country	:	US
Telephone Number	:	253-564-2570
Fax Number	:	253-564-2652

Provider Business Practice Location Address
First Line	:	1033 REGENTS BLVD
Second Line	:	SUITE 201
City	:	FIRCREST
State	:	WA
Zip	:	98466-6045
Country	:	US
Telephone Number	:	253-564-2570
Fax Number	:	253-564-2652

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

Provider Enumeration Date	:	01/27/2006
Last Update Date	:	05/13/2013

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