Provider Demographics
NPI:1578162525
Name:KAGY FAMILY DENTAL
Entity Type:Organization
Organization Name:KAGY FAMILY DENTAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:CORY
Authorized Official - Middle Name:
Authorized Official - Last Name:SAGER
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:406-579-5998
Mailing Address - Street 1:45 W KAGY BLVD STE 4
Mailing Address - Street 2:
Mailing Address - City:BOZEMAN
Mailing Address - State:MT
Mailing Address - Zip Code:59715-6052
Mailing Address - Country:US
Mailing Address - Phone:406-579-5998
Mailing Address - Fax:
Practice Address - Street 1:45 W KAGY BLVD STE 4
Practice Address - Street 2:
Practice Address - City:BOZEMAN
Practice Address - State:MT
Practice Address - Zip Code:59715-6052
Practice Address - Country:US
Practice Address - Phone:406-579-5998
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:PEAK DENTAL, PC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2020-10-21
Last Update Date:2020-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty