Organization
MELINDA L. WAGNER DMD LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MELINDA L. WAGNER DMD (OWNER)
(732) 747-2022
Entity
Organization
Contact information
Practice address
191 BROAD ST., RED BANK, NJ 07701
(732) 747-2022
(732) 747-5524
Mailing address
191 BROAD ST., RED BANK, NJ 07701
(732) 747-2022
(732) 747-5524
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
14142
NJ
Other
Enumeration date
04/14/2011
Last updated
04/14/2011
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