RICHARD W WAGNER

SIOUX CITY, IA
NPI1710050893
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics
(Licence: IA  6637)
Enumeration Date2006-11-16
Last Update Date2007-07-08
Business Address
-- RICHARD W WAGNER DDS MS
3012 HAMILTON BLVD
SIOUX CITY, IA 51104
Phone number: 712-258-0501
Mailing Address
-- RICHARD W WAGNER DDS MS
3012 HAMILTON BLVD
SIOUX CITY, IA 51104
Phone number: 712-258-0501
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