Organization
WADE W. WAGNER, D.D.S., CHTD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. WADE W. WAGNER SR. D.D.S. (OWNER)
(702) 877-2222
Entity
Organization
Contact information
Practice address
4618 MEADOWS LN, LAS VEGAS, NV 89107-2956
(702) 877-2222
Mailing address
4618 MEADOWS LN, LAS VEGAS, NV 89107-2956
(702) 877-2222
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
3199
NV
Other
Enumeration date
03/29/2007
Last updated
08/22/2020
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