Jonathon Wagner DDS

NPI 1063505477 - Dentist - 1223G0001X

NPI Details
NPI 1063505477
Gender Male
Enumeration Date 09/30/2006
Last Updated 07/08/2007
Entity Type Individual
Active Over 10 years ago
Practice Location
1017 MISSION STREET
SANTA CRUZ CA, 95060, US
Phone (831) 426-3535
Fax (831) 454-0330
Business Location
1017 MISSION STREET
SANTA CRUZ CA, 95060, US
Phone (831) 426-3535
Fax (831) 454-0330
Toxanomy
Taxonomy Code 1223G0001X
License State California
License Number 50395
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According to our database, Dr. Jonathon Wagner DDS NPI is 1063505477, taxonomy code is 1223G0001X and license number is 50395, license state is located at California. Jonathon Wagner DDS physically located at 1017 Mission Street, Santa Cruz CA, 95060. NPI Number Jonathon Wagner DDS has the Individual type.

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1063505477 NPI number is provided on an as is basis without warranty of any kind. 1063505477 is maintained by the National Plan & Provider Enumeration System. The contents of Jonathon Wagner DDS are for informational purposes only.