BRANDON MARK WAGNER

BOISE, ID
NPI1265002901
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy1223G0001X Dentist, General Practice
(Licence: ID  D-5306)
Enumeration Date2021-06-25
Last Update Date2025-09-08
Business Address
Dr. BRANDON MARK WAGNER DDS
403 S 11TH ST STE 200
BOISE, ID 83702-6968
Phone number: 208-342-3440
Mailing Address
Dr. BRANDON MARK WAGNER DDS
403 S 11TH ST STE 200
BOISE, ID 83702-6968
Phone number: 208-342-3440
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