Individual
EDWIN L WAGSTAFF
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
150 N SOUTH ST, WILMINGTON, OH 45177-1647
(937) 382-2041
Mailing address
150 N SOUTH ST, WILMINGTON, OH 45177-1647
(937) 382-2041
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
30014341
OH
Other
Enumeration date
05/14/2007
Last updated
07/08/2007
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