Organization
IRVING H. WAGMAN DDS PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JEFFREY DAVID WAGMAN D.D.S. (OWNER)
(703) 379-6187
Entity
Organization
Contact information
Practice address
3541 W BRADDOCK RD, SUITE 202, ALEXANDRIA, VA 22302-1915
(703) 379-6187
(703) 379-8656
Mailing address
3541 W BRADDOCK RD, SUITE 202, ALEXANDRIA, VA 22302-1915
(703) 379-6187
(703) 379-8656
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
0401008271
VA
Other
Enumeration date
05/10/2007
Last updated
08/22/2020
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