Nicholas J Wagner, Dds, Llc

NPI 1306231717 - Dentist - 122300000X

NPI Details
NPI 1306231717
Enumeration Date 04/02/2015
Last Updated 04/02/2015
Entity Type Healthcare Provider
Active Over 1 year ago
Authorized Information
Name NICHOLAS J NICHOLAS
Position DENTIST/OWNER
Phone (812) 897-4889
Fax
Practice Location
800 OFFICE PARK DR
BOONVILLE IN, 47601-8601, US
Phone (812) 897-4889
Fax
Business Location
800 OFFICE PARK DR
BOONVILLE IN, 47601-8601, US
Phone (812) 897-4889
Fax
Toxanomy
Taxonomy Code 122300000X
License State Indiana
License Number 12011465A
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According to our database, Nicholas J Wagner, Dds, Llc NPI is 1306231717, taxonomy code is 122300000X and license number is 12011465A, license state is located at Indiana. Nicholas J Wagner, Dds, Llc physically located at 800 Office Park Dr, Boonville IN, 47601-8601. NPI Number 1033115704 has the healthcare provider type.

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1306231717 NPI number is provided on an as is basis without warranty of any kind. 1306231717 is maintained by the National Plan & Provider Enumeration System. The contents of Nicholas J Wagner, Dds, Llc are for informational purposes only.