Provider Demographics
NPI:1225442833
Name:NAGEL, KATIE ELIZABETH (DDS)
Entity Type:Individual
Prefix:DR
First Name:KATIE
Middle Name:ELIZABETH
Last Name:NAGEL
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1202 GREENE ST
Mailing Address - Street 2:
Mailing Address - City:ADEL
Mailing Address - State:IA
Mailing Address - Zip Code:50003-1714
Mailing Address - Country:US
Mailing Address - Phone:515-993-3701
Mailing Address - Fax:515-993-2072
Practice Address - Street 1:1202 GREENE ST
Practice Address - Street 2:
Practice Address - City:ADEL
Practice Address - State:IA
Practice Address - Zip Code:50003-1714
Practice Address - Country:US
Practice Address - Phone:515-993-3701
Practice Address - Fax:515-993-2072
Is Sole Proprietor?:No
Enumeration Date:2014-06-12
Last Update Date:2014-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA090861223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice