MRS. Alexis Dawn Wagoner, DA
NPI #1083700231 in Longview, Washington
Provider Information
- NPI Number
- 1083700231
- Entity Type
- Individual
- Name
- MRS. Alexis Dawn Wagoner, DA
- Gender
- Not Specified
- Sole Proprietor
- Yes
- Primary Specialty
- Dental Assistant
- Credential
- DA
- Enumeration Date
- Oct 5, 2006
- Last Updated
- Jul 8, 2007
Practice Location
- Address
- 3902 COTTONWOOD ST
- City
- Longview
- State
- Washington
- ZIP Code
- 98632-4911
- Phone
- (360) 425-7753
Specialties & Taxonomy Codes
| Specialty |
|---|
| Dental Assistant |
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