DR. Tara Marie Wagner, DDS
NPI #1396840559 in White Bear Lake, Minnesota
Provider Information
- NPI Number
- 1396840559
- Entity Type
- Individual
- Name
- DR. Tara Marie Wagner, DDS
- Gender
- Not Specified
- Sole Proprietor
- No
- Primary Specialty
- Dentist
- Credential
- DDS
- Enumeration Date
- Sep 13, 2006
- Last Updated
- Jul 8, 2007
Practice Location
- Address
- 4700 WHITE BEAR PARKWAY
- City
- White Bear Lake
- State
- Minnesota
- ZIP Code
- 55110-3336
- Phone
- (651) 762-7677
Specialties & Taxonomy Codes
| Specialty |
|---|
| Dentist |
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