NPI | 1689053597 |
---|---|
Doing Business As | TAYLOR WAGNER FAMILY DENTISTRY |
Entity Type | Organization |
Authorized Contact | KATY WAGNER Owner 870-972-6985 |
Organization Subpart ? | No |
Primary Taxonomy | 122300000X Dentist |
Enumeration Date | 2015-05-26 |
Last Update Date | 2015-05-26 |