Individual
JAMISON JENKINS WAGNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
263 COUNTRY CLB STE 103, STANSBURY PARK, UT 84074-9602
(801) 918-0960
Mailing address
3042 E 3900 S, SALT LAKE CITY, UT 84124-2042
(801) 918-0960
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
13420053-9921
UT
Other
Enumeration date
05/22/2023
Last updated
05/22/2023
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