Individual
MARCIE WAGNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RDH
Contact information
Practice address
155 5TH ST, SAN FRANCISCO, CA 94103-2919
(415) 342-9633
Mailing address
13 ROOSEVELT AVE, SAN RAFAEL, CA 94903-4109
(415) 342-9633
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
29141
CA
Other
Enumeration date
07/27/2023
Last updated
07/28/2023
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