Organization
ROBERT H WAGNER FAMILY DENTIST S.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ROBERT HAROLD WAGNER DDS (DENTIST/OWNER)
(920) 432-7230
Entity
Organization
Contact information
Practice address
2830 CURRY COURT, SUITE 1, GREEN BAY, WI 54311
(920) 432-7230
(920) 432-6948
Mailing address
2830 CURRY COURT, SUITE 1, GREEN BAY, WI 54311
(920) 432-7230
(920) 432-6948
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
33487700
—
WI
Enumeration date
07/12/2019
Last updated
07/12/2019
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