BOUAKEO WAGNER

SALEM, OR
NPI1386731792
Other NameMARYANN WAGNER
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy124Q00000X Dental Hygienist
(Licence: OR  H4345)
Enumeration Date2006-10-06
Last Update Date2007-07-08
Business Address
-- BOUAKEO WAGNER R.D.H.
190 KINGWOOD AVE NW
SALEM, OR 97304-4030
Phone number: 503-315-0712
Mailing Address
-- BOUAKEO WAGNER R.D.H.
14670 SE SALMON ST
PORTLAND, OR 97233-2568
Phone number: 503-949-4427
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