KEVIN JOSEPH WAGNER

POCATELLO, ID
NPI1558094508
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy122300000X Dentist
(Licence: ID  D-5422)
Enumeration Date2022-07-07
Last Update Date2022-07-07
Business Address
Dr. KEVIN JOSEPH WAGNER DMD
921 S 8TH AVENUE STOP 8088
POCATELLO, ID 83201
Phone number: 609-923-0168
Mailing Address
Dr. KEVIN JOSEPH WAGNER DMD
4170 HAWTHORNE RD APT A307
CHUBBUCK, ID 83202-2738
Phone number:
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