Individual
DR. YEN T WAGNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
3965 N MERIDIAN ST APT 1C, INDIANAPOLIS, IN 46208-4035
(317) 925-5811
Mailing address
3965 N MERIDIAN ST APT 1C, INDIANAPOLIS, IN 46208-4035
(317) 925-5811
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
12010286A
IN
1223G0001X
General Practice Dentistry
53337
CA
Other
Enumeration date
01/11/2006
Last updated
07/30/2009
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