Provider Demographics
NPI:1134640816
Name:NAGLE, WILLIAM IAN (DDS)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:IAN
Last Name:NAGLE
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 1:1201 AGORA DR STE 2B
Mailing Address - Street 2:
Mailing Address - City:BEL AIR
Mailing Address - State:MD
Mailing Address - Zip Code:21014-6859
Mailing Address - Country:US
Mailing Address - Phone:410-978-7982
Mailing Address - Fax:
Practice Address - Street 1:1201 AGORA DR STE 2B
Practice Address - Street 2:
Practice Address - City:BEL AIR
Practice Address - State:MD
Practice Address - Zip Code:21014-6859
Practice Address - Country:US
Practice Address - Phone:410-978-7982
Practice Address - Fax:410-978-7982
Is Sole Proprietor?:No
Enumeration Date:2017-07-03
Last Update Date:2019-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD164251223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice