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1174580120
JEFFREY PAUL WAGNER
ALBUQUERQUE, NM
NPI
1174580120
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
122300000X Dentist
(Licence: NM 1265)
Enumeration Date
2006-04-26
Last Update Date
2007-07-08
Business Address
Dr. JEFFREY PAUL WAGNER DDS
1501 SAN PEDRO DR SE
ALBUQUERQUE, NM 87108-5153
Phone number: 505-256-2778
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Mailing Address
Dr. JEFFREY PAUL WAGNER DDS
7527 JACOBO DR NE
ALBUQUERQUE, NM 87109-6425
Phone number: 505-821-4415
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