Individual
DR. CRAIG A WAGLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS MD
Contact information
Practice address
5437 MAHONING AVE, SUITE 12, AUSTINTOWN, OH 44515-2437
(330) 792-2501
(330) 792-9249
Mailing address
5437 MAHONING AVE, SUITE 12, AUSTINTOWN, OH 44515-2437
(330) 792-2501
(330) 792-9249
Taxonomy
Speciality
Code
Description
License number
State
204E00000X
Oral & Maxillofacial Surgery (D.M.D.)
Primary
21078
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2134630
—
OH
Enumeration date
12/16/2005
Last updated
02/08/2008
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