Individual
DR. DAVID F WAGNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
11A FLORENCE ST, MARLBOROUGH, MA 01752-2822
(508) 485-0401
(508) 786-5900
Mailing address
11A FLORENCE ST, MARLBOROUGH, MA 01752-2822
(508) 485-0401
(508) 786-5900
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
17039
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
17039
LICENSE NUMBER
MA
Enumeration date
08/19/2006
Last updated
07/08/2007
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