Organization
DAVID A. WAGNER, DMD, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DAVID A WAGNER SR. D.M.D. (PRESIDENT)
(828) 894-8291
Entity
Organization
Contact information
Practice address
43 EAST MILLS STREET, COLUMBUS, NC 28722
(828) 894-8291
(828) 894-5124
Mailing address
PO BOX 275, COLUMBUS, NC 28722-0275
(828) 894-8291
(828) 894-5124
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
015MP
BCBS
NC
Enumeration date
11/15/2006
Last updated
08/22/2020
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