Individual
DR. JOHN WILLIAM WAGNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
2211 N 56TH ST, SEATTLE, WA 98103-6203
(206) 632-1313
Mailing address
7701 LAKEMONT DR NE, SEATTLE, WA 98115-5234
(206) 523-7175
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
3745
WA
Other
Enumeration date
07/26/2005
Last updated
07/08/2007
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