Charles Allen Wagner, DDS

NPI #1982760153 in Medford, Oregon

Provider Information

NPI Number: 1982760153
Entity Type: Individual
Name: Charles Allen Wagner, DDS
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Dentist - General Practice
Credential: DDS
Enumeration Date: Dec 29, 2006
Last Updated: Jun 4, 2015

Practice Location

Address: 773 GOLF VIEW DR
City: Medford
State: Oregon
ZIP Code: 97504-9643
Phone: (541) 857-2790

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist - General Practice — General Practice	1223G0001X	Primary

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