| NPI | 1063539963 |
|---|---|
| Former Legal Business Name | JOSHUA G. WAGNER DDS PC |
| Entity Type | Organization |
| Authorized Contact | ERIKA LAYTON BOSSI Patient Coordinator 307-732-2273 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice |
| Enumeration Date | 2007-03-23 |
| Last Update Date | 2010-06-01 |