Individual
DR. LAUREN M WAGNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
1126 W PEARCE BLVD STE 110, WENTZVILLE, MO 63385-1053
(636) 327-5188
(636) 332-9223
Mailing address
15363 RED WILLOW CT, CHESTERFIELD, MO 63017-5426
(414) 975-6675
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
2021021151
MO
Other
Enumeration date
06/14/2021
Last updated
11/11/2021
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