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Individual

DR. TODD S WRAGGE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DDS

Contact information

Practice address
102 E MAIN ST, PIERCE, NE 68767-1344
(402) 329-6850
(402) 329-4912
Mailing address
102 E MAIN ST, PIERCE, NE 68767-1344
(402) 329-6850
(402) 329-4912

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
6197
NE

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
71-0923757-00
NE
01
7254
BCBS PROVIDER NUMBER
NE
Enumeration date
06/29/2007
Last updated
07/08/2007
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