DR. Kevin Joseph Wagner, DMD

NPI #1558094508 in Pocatello, Idaho

Provider Information

NPI Number: 1558094508
Entity Type: Individual
Name: DR. Kevin Joseph Wagner, DMD
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Dentist
Credential: DMD
Enumeration Date: Jul 7, 2022
Last Updated: Jul 7, 2022

Practice Location

Address: 921 S 8TH AVENUE STOP 8088
City: Pocatello
State: Idaho
ZIP Code: 83201
Phone: (609) 923-0168

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist	122300000X	Primary

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