Wagner Dental LLC

NPI #1003216698 in Las Vegas, Nevada

Provider Information

NPI Number: 1003216698
Entity Type: Organization
Organization Name: Wagner Dental LLC
Primary Specialty: Dentist
Enumeration Date: Sep 2, 2014
Last Updated: Sep 2, 2014

Practice Location

Address: 2045 VILLAGE CENTER CIR
City: Las Vegas
State: Nevada
ZIP Code: 89134-6251
Phone: (702) 878-5599

Authorized Official

Name: RONALD KENT WAGNER JR., DDS
Title: MANAGER
Phone: (702) 878-5599

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist	122300000X	Primary

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