Individual
DR. CARSON B WAGSTAFF
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.M.D.
Contact information
Practice address
13435 N LON ADAMS RD, MARANA, AZ 85653
(520) 989-0270
Mailing address
1225 W MOODIE DR, ORO VALLEY, AZ 85755-6000
(801) 979-2035
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
D-4299
ID
Other
Enumeration date
07/06/2010
Last updated
12/11/2013
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