Organization
POCOMOKE DENTAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. STEPHEN T WAGNER DDS (PRESIDENT)
(410) 957-0788
Entity
Organization
Contact information
Practice address
102 8TH ST, POCOMOKE CITY, MD 21851-1129
(410) 957-0788
(410) 957-0813
Mailing address
102 8TH ST, POCOMOKE CITY, MD 21851-1129
(410) 957-0788
(410) 957-0813
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
14543
MD
Other
Enumeration date
01/14/2011
Last updated
09/27/2011
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