LESLIE WAGNER
Dentist - General Practice
Active
Individual
NPI: 1639699036
Specialties
| Specialty | Code | Primary | License |
|---|---|---|---|
| Dentist - General Practice | 1223G0001X | Yes | D4846 (ID) |
Frequently Asked Questions
NPI 1639699036 is the National Provider Identifier for LESLIE WAGNER, a Dentist - General Practice provider located in Boise, ID. This NPI was enumerated on June 27, 2017.
LESLIE WAGNER practices at 1212 N COLE RD, Boise, ID 83704.
Quick Facts
- NPI
- 1639699036
- Type
- Individual
- Enumerated
- Jun 27, 2017
- Last Updated
- Mar 17, 2018
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