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Organization
LEHMAN WAGGENER PROFESSIONAL DENTAL CORPORATION
Active
Organization
LEHMAN WAGGENER PROFESSIONAL DENTAL CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KELLY JOHANNA WAGGENER DMD (PRESIDENT)
(707) 538-3325
Entity
Organization
Contact information
Practice address
80 DOCTORS PARK DRIVE, SANTA ROSA, CA 95405
(707) 544-1836
(707) 542-0617
Mailing address
80 DOCTORS PARK DRIVE, SANTA ROSA, CA 95405
(707) 544-1836
(707) 542-0617
Taxonomy
Speciality
Code
Description
License number
State
1223E0200X
Endodontics
—
—
1223G0001X
General Practice Dentistry
Primary
—
—
1223P0300X
Periodontics
—
—
Other
Enumeration date
02/09/2007
Last updated
09/11/2025
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