Gary Wayne Wagner D.M.D.

NPI 1083717946 - Dentist - 1223E0200X

NPI Details
NPI 1083717946
Gender Male
Enumeration Date 09/06/2006
Last Updated 07/08/2007
Entity Type Individual
Active Over 10 years ago
Practice Location
2525 W ILES AVE
SPRINGFIELD IL, 62704-4283, US
Phone (217) 787-2600
Fax
Business Location
2525 W ILES AVE
SPRINGFIELD IL, 62704-4283, US
Phone (217) 787-2600
Fax
Toxanomy
Taxonomy Code 1223E0200X
License State
License Number
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According to our database, Dr. Gary Wayne Wagner D.M.D. NPI is 1083717946, taxonomy code is 1223E0200X Gary Wayne Wagner D.M.D. physically located at 2525 W Iles Ave, Springfield IL, 62704-4283. NPI Number Gary Wayne Wagner D.M.D. has the Individual type.

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1083717946 NPI number is provided on an as is basis without warranty of any kind. 1083717946 is maintained by the National Plan & Provider Enumeration System. The contents of Gary Wayne Wagner D.M.D. are for informational purposes only.