DR. Katie-Rose Radin Wagner, DDS

NPI #1760793087 in Somerville, Massachusetts

Provider Information

NPI Number: 1760793087
Entity Type: Individual
Name: DR. Katie-Rose Radin Wagner, DDS
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Dentist
Credential: DDS
Enumeration Date: Jul 1, 2010
Last Updated: Mar 19, 2012

Practice Location

Address: 6 KENSINGTON AVE
City: Somerville
State: Massachusetts
ZIP Code: 02145-2107
Phone: (617) 623-2100

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist	122300000X	Primary

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