Individual
DR. WELLS WESLEY WAGNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
6973 COUGAR LN, SUITE D, WEST JORDAN, UT 84084-7927
(801) 982-0332
Mailing address
6973 COUGAR LN, SUITE D, WEST JORDAN, UT 84084-7927
(801) 982-0332
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
3082999-9922
UT
Other
Enumeration date
02/01/2007
Last updated
07/08/2007
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