MEDICARE: HOWARD JAMES NAGLE JR. DMD

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	122300000X	Dentist	DS025936L	PA

General Provider Information

NPI Number	:	1407959950
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HOWARD JAMES NAGLE JR. DMD

Provider Business Mailing Address
First Line	:	1951 SHENANGO VALLEY FREEWAY
Second Line	:	PINEWOOD PLACE SUITE 4 NORTH
City	:	HERMITAGE
State	:	PA
Zip	:	16148
Country	:	US
Telephone Number	:	724-347-1355
Fax Number	:	724-982-0533

Provider Business Practice Location Address
First Line	:	1951 SHENANGO VALLEY FREEWAY
Second Line	:	PINEWOOD PLACE SUITE 4 NORTH
City	:	HERMITAGE
State	:	PA
Zip	:	16148
Country	:	US
Telephone Number	:	724-347-1355
Fax Number	:	724-982-0533

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

Provider Enumeration Date	:	09/07/2006
Last Update Date	:	07/08/2007

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