Individual
DR. MICHAEL WAGNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
754 S MAIN ST STE 1, ST GEORGE, UT 84770-5510
(435) 674-9777
Mailing address
664 SWEETSPRING DR, SANTA CLARA, UT 84765-5469
(435) 313-6221
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
11331177-9922
UT
Other
Enumeration date
06/17/2019
Last updated
06/17/2019
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