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Individual
DR. ROBERT GENE WAGONER II
Active
Individual
DR. ROBERT GENE WAGONER II
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DMD MD
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
7298
KY
204E00000X
Oral & Maxillofacial Surgery (D.M.D.)
Primary
7298
KY
Other
Enumeration date
11/02/2006
Last updated
09/04/2012
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