Provider Demographics
NPI:1043281165
Name:GAGLIARDI, JAMES PATRICK (DDS)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:PATRICK
Last Name:GAGLIARDI
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1033 REGENTS BLVD
Mailing Address - Street 2:SUITE 201
Mailing Address - City:FIRCREST
Mailing Address - State:WA
Mailing Address - Zip Code:98466-6045
Mailing Address - Country:US
Mailing Address - Phone:253-564-2570
Mailing Address - Fax:253-564-2652
Practice Address - Street 1:1033 REGENTS BLVD
Practice Address - Street 2:SUITE 201
Practice Address - City:FIRCREST
Practice Address - State:WA
Practice Address - Zip Code:98466-6045
Practice Address - Country:US
Practice Address - Phone:253-564-2570
Practice Address - Fax:253-564-2652
Is Sole Proprietor?:No
Enumeration Date:2006-01-27
Last Update Date:2013-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADE000051221223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice