| NPI | 1003465964 | 
|---|---|
| Doing Business As | WAGNER ORTHODONTICS | 
| Entity Type | Organization | 
| Authorized Contact | KRISTIN LINK Office Manager 360-748-6636  | 
| Organization Subpart ? | Yes | 
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics | 
| Enumeration Date | 2019-09-04 | 
| Last Update Date | 2024-09-20 |