Provider Demographics
NPI:1891164760
Name:NAGEL, ANNE E (DDS)
Entity Type:Individual
Prefix:DR
First Name:ANNE
Middle Name:E
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 1:18035 BUSHARD ST
Mailing Address - Street 2:
Mailing Address - City:FOUNTAIN VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:92708-5760
Mailing Address - Country:US
Mailing Address - Phone:714-962-1306
Mailing Address - Fax:
Practice Address - Street 1:18035 BUSHARD ST
Practice Address - Street 2:
Practice Address - City:FOUNTAIN VALLEY
Practice Address - State:CA
Practice Address - Zip Code:92708-5760
Practice Address - Country:US
Practice Address - Phone:714-962-1306
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-09-21
Last Update Date:2015-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA65103122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist