Kent Wagner Jr DDS PC

NPI #1336157270 in Las Vegas, Nevada

Provider Information

NPI Number: 1336157270
Entity Type: Organization
Organization Name: Kent Wagner Jr DDS PC
Primary Specialty: Dentist
Enumeration Date: Aug 4, 2006
Last Updated: Aug 22, 2020

Practice Location

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

Authorized Official

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

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist	122300000X	Primary

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