# DR. ROBERT SCOTT WAGNER

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1114017241
- **Gender:** Man
- **Credential:** DDS

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 122300000X | Dentist | 051232 | NY | — |
| 122300000X | Dentist | 6248 | VA | Yes |

## Other

- **Enumeration date:** 10/12/2006
- **Last updated:** 10/02/2007