Organization
WAGGONER & ASSOCIATES PC
Active
Other names
Kids' Dental Safari
Organization subpart
No
Provider details
NPI number
Authorized official
DR. WILLIAM WAGGONER DDS, MS (PRESIDENT)
(702) 254-4220
Entity
Organization
Contact information
Practice address
2381B RENAISSANCE DR, LAS VEGAS, NV 89119-6498
(702) 373-9526
Mailing address
8981 W SAHARA AVE, SUITE 110, LAS VEGAS, NV 89117-5897
(702) 254-4220
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
S6-17
NV
Other
Enumeration date
10/09/2014
Last updated
10/09/2014
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