Individual
DR. BRIAN JAMES WAGGLE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
4063 NORTHPOINTE DR, ZANESVILLE, OH 43701-7647
(740) 454-6644
(740) 588-0950
Mailing address
4063 NORTHPOINTE DR, ZANESVILLE, OH 43701-7647
(740) 454-6644
(740) 588-0950
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
19787
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0168214
—
OH
01
—
311626180
FEDERAL TAX ID
OH
Enumeration date
12/19/2006
Last updated
07/23/2013
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