Provider Demographics
NPI:1780715714
Name:NANGLE, DAVID G (DDS)
Entity type:Individual
Prefix:DR
First Name:DAVID
Middle Name:G
Last Name:NANGLE
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 1:200 MCINTOSH DR.
Mailing Address - Street 2:
Mailing Address - City:AUBURN
Mailing Address - State:NY
Mailing Address - Zip Code:13021-9495
Mailing Address - Country:US
Mailing Address - Phone:315-685-1914
Mailing Address - Fax:
Practice Address - Street 1:200 MCINTOSH DR.
Practice Address - Street 2:
Practice Address - City:AUBURN
Practice Address - State:NY
Practice Address - Zip Code:13021-1246
Practice Address - Country:US
Practice Address - Phone:315-253-4902
Practice Address - Fax:315-253-4902
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-09
Last Update Date:2008-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0385411223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice