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1710050893
RICHARD W WAGNER
SIOUX CITY, IA
NPI
1710050893
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics
(Licence: IA 6637)
Enumeration Date
2006-11-16
Last Update Date
2007-07-08
Business Address
-- RICHARD W WAGNER DDS MS
3012 HAMILTON BLVD
SIOUX CITY, IA 51104
Phone number: 712-258-0501
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Mailing Address
-- RICHARD W WAGNER DDS MS
3012 HAMILTON BLVD
SIOUX CITY, IA 51104
Phone number: 712-258-0501
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