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1578732467
SPENCER B WAGNER
PROVO, UT
NPI
1578732467
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
122300000X Dentist
(Licence: SC 3192)
Additional Taxonomies
122300000X Dentist
(Licence: UT 6026130)
Enumeration Date
2008-02-25
Last Update Date
2013-01-04
Business Address
DR. SPENCER B WAGNER D.M.D
2520 N UNIVERSITY AVE SUITE 101
PROVO, UT 84604-3804
Phone number: 801-426-6255
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Mailing Address
DR. SPENCER B WAGNER D.M.D
2520 N UNIVERSITY AVE SUITE 101
PROVO, UT 84604-3804
Phone number: 801-426-6255
Copy
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