LESLIE A WAGNER

BOISE, ID
NPI1639699036
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy1223G0001X Dentist General Practice
(Licence: ID  D4846)
Enumeration Date2017-06-27
Last Update Date2018-03-17
Business Address
LESLIE A WAGNER
1212 N COLE RD
BOISE, ID 83704-8646
Phone number: 208-901-7451
Mailing Address
LESLIE A WAGNER
4239 E HARDESTY CT
BOISE, ID 83716
Phone number: 208-869-5139
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