SPENCER B WAGNER

PROVO, UT
NPI1578732467
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy122300000X Dentist
(Licence: SC  3192)
Additional Taxonomies122300000X Dentist
(Licence: UT  6026130)
Enumeration Date2008-02-25
Last Update Date2013-01-04
Business Address
Dr. SPENCER B WAGNER D.M.D
2520 N UNIVERSITY AVE SUITE 101
PROVO, UT 84604-3804
Phone number: 801-426-6255
Mailing Address
Dr. SPENCER B WAGNER D.M.D
2520 N UNIVERSITY AVE SUITE 101
PROVO, UT 84604-3804
Phone number: 801-426-6255