Individual
DR. ROBERT FREDERICK WAGNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.M.D.
Contact information
Practice address
2803 NE EVERETT ST, PORTLAND, OR 97232-3246
(503) 239-5115
(503) 231-6480
Mailing address
2803 NE EVERETT ST, PORTLAND, OR 97232-3246
(503) 239-5115
(503) 231-6480
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
D7549
OR
Other
Enumeration date
11/29/2006
Last updated
07/08/2007
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