Individual
DR. SHANCIE JENEE WAGNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.D.S.
Contact information
Practice address
2211 E HARTSON AVE, SPOKANE, WA 99202-4152
(509) 444-8200
Mailing address
611 N IRON BRIDGE WAY, SPOKANE, WA 99202-4932
(509) 444-8888
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DE60294772
WA
1223G0001X
General Practice Dentistry
60294772
WA
Other
Enumeration date
06/04/2012
Last updated
03/04/2021
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