Organization
CARSON B. WAGSTAFF, DMD, PLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CARSON B WAGSTAFF DMD (OWNER)
(801) 979-2035
Entity
Organization
Contact information
Practice address
13435 N LON ADAMS RD, MARANA, AZ 85653
(801) 979-2035
Mailing address
13435 N LON ADAMS RD, MARANA, AZ 85653
(801) 979-2035
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
12/13/2013
Last updated
12/13/2013
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