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Individual
DR. MARK BENNETT WAGGONER
Active
Individual
DR. MARK BENNETT WAGGONER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Taxonomy
Speciality
Code
Description
License number
State
1223D0004X
Dental Anesthesiology
13820
TX
1223G0001X
General Practice Dentistry
Primary
13820
TX
Other
Enumeration date
03/29/2007
Last updated
10/23/2014
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