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Individual
DR. TODD S WRAGGE
Active
Individual
DR. TODD S WRAGGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
6197
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
71-0923757-00
—
NE
01
—
7254
BCBS PROVIDER NUMBER
NE
Enumeration date
06/29/2007
Last updated
07/08/2007
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