Wagner Family Dental

NPI #1104209790 in Jasper, Indiana

Provider Information

NPI Number: 1104209790
Entity Type: Organization
Organization Name: Wagner Family Dental
Primary Specialty: Dentist
Enumeration Date: Jul 1, 2015
Last Updated: Jul 1, 2015

Practice Location

Address: 4115 MANNHEIM RD
City: Jasper
State: Indiana
ZIP Code: 47546-2964
Phone: (812) 482-4347

Authorized Official

Name: DR. BRIAN M. WAGNER, DDS
Title: OWNER
Phone: (812) 482-4347

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist	122300000X	Primary

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