Individual
DR. RUDOLPH MICHAEL WAGNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.M.D.
Contact information
Practice address
2595 TAMPA RD STE I, PALM HARBOR, FL 34684-3131
(727) 785-8847
(277) 785-9372
Mailing address
2595 TAMPA RD STE I, PALM HARBOR, FL 34684-3131
(727) 785-8847
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
21125
FL
Other
Enumeration date
05/20/2009
Last updated
07/20/2021
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