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Individual

DR. WILLIAM F. WAGGONER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
D.D.S., M.S.

Contact information

Practice address
8981 W SAHARA AVE STE 110, LAS VEGAS, NV 89117-5894
(702) 254-4220
Mailing address
8981 W SAHARA AVE STE 110, LAS VEGAS, NV 89117-5894
(702) 254-4220

Taxonomy

Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
S617
NV

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00220202310
NV
01
826768
UNITED CONCORDIA
Enumeration date
02/28/2006
Last updated
07/13/2009
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