# WAGNER DENTAL

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Garrettsville Dental Group
- **Organization subpart:** No

## Provider details

- **NPI number:** 1386492239
- **Authorized official:** BRYAN WAGNER DMD (DENTIST)
- **Authorized official phone:** (614) 425-5821

## Contact information

- **Practice address:** 10699 FREEDOM ST, GARRETTSVILLE, OH 44231-1130
- **Practice address phone:** (330) 527-4313
- **Mailing address:** 10699 FREEDOM ST, GARRETTSVILLE, OH 44231-1130
- **Mailing address phone:** (330) 527-4313

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QD0000X | Dental Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 05/07/2024
- **Last updated:** 05/07/2024