Individual
DR. NICHOLAS WEGNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
550 UNIVERSITY BLVD # UH-3143, INDIANAPOLIS, IN 46202-5149
(317) 274-5315
Mailing address
105 BEN CASEY DR, STE 115, FORT MILL, SC 29708-8557
(803) 548-9910
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
9832
SC
Other
Enumeration date
05/19/2017
Last updated
09/21/2021
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