MICHAEL WAGNER, DDS
Dentist
Active
Individual
NPI: 1639114622
Specialties
| Specialty | Code | Primary | License |
|---|---|---|---|
| Dentist | 122300000X | Yes | 2342 (RI) |
Frequently Asked Questions
NPI 1639114622 is the National Provider Identifier for MICHAEL WAGNER, DDS, a Dentist provider located in Pawtucket, RI. This NPI was enumerated on June 17, 2006.
MICHAEL WAGNER, DDS practices at 480 BROADWAY, Pawtucket, RI 02860.
Quick Facts
- NPI
- 1639114622
- Type
- Individual
- Enumerated
- Jun 17, 2006
- Last Updated
- Jul 8, 2007
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GATEWAY HEALTHCARE, INC
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THOMAS RODRIGUES
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DANIEL REYES, MASTERS
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DONNA RENSHAW
Counselor