Individual
DR. DAVID EDWIN WAGNER
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
5992 HOWDERSHELL RD, STE 206, HAZELWOOD, MO 63042-4107
(314) 731-2273
(314) 731-2096
Mailing address
5992 HOWDERSHELL RD, STE 206, HAZELWOOD, MO 63042-4107
(314) 731-2273
(314) 731-2096
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
14071
MO
Other
Enumeration date
10/03/2005
Last updated
07/08/2007
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