Provider Demographics
NPI:1992707301
Name:NAIL, JAMES GARY (DDS)
Entity type:Individual
Prefix:DR
First Name:JAMES
Middle Name:GARY
Last Name:NAIL
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 1:1200 E WOODHURST DR
Mailing Address - Street 2:BUILDING M, SUITE 400
Mailing Address - City:SPRINGFIELD
Mailing Address - State:MO
Mailing Address - Zip Code:65804-4257
Mailing Address - Country:US
Mailing Address - Phone:417-881-1212
Mailing Address - Fax:
Practice Address - Street 1:1200 E WOODHURST DR
Practice Address - Street 2:BUILDING M, SUITE 400
Practice Address - City:SPRINGFIELD
Practice Address - State:MO
Practice Address - Zip Code:65804-4257
Practice Address - Country:US
Practice Address - Phone:417-881-1212
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-08-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MODE120921223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice