Individual
REINA MARCELA WAGGENER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RDH
Contact information
Practice address
4520 N CENTRAL AVE, PHOENIX, AZ 85012-1828
(602) 279-5262
Mailing address
2227 E ROMA AVE, PHOENIX, AZ 85016-5527
(602) 728-0758
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
5215
AZ
Other
Enumeration date
02/08/2009
Last updated
02/08/2009
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