Provider Demographics
NPI:1417172099
Name:BAGLEY, NILA CATHRYN (RDH)
Entity Type:Individual
Prefix:MRS
First Name:NILA
Middle Name:CATHRYN
Last Name:BAGLEY
Suffix:
Gender:F
Credentials:RDH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2301 TIMBERMAN ROAD
Mailing Address - Street 2:
Mailing Address - City:HAMILTON
Mailing Address - State:OH
Mailing Address - Zip Code:45013
Mailing Address - Country:US
Mailing Address - Phone:513-863-8568
Mailing Address - Fax:
Practice Address - Street 1:3540 SPRINGDALE ROAD
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45251
Practice Address - Country:US
Practice Address - Phone:513-385-8482
Practice Address - Fax:513-385-5705
Is Sole Proprietor?:No
Enumeration Date:2007-04-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH002216124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist