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1740393917
EDWARD C WAGNER
BOISE, ID
NPI
1740393917
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
1223G0001X Dentist, General Practice
(Licence: ID 3528)
Enumeration Date
2006-08-15
Last Update Date
2007-07-08
Business Address
-- EDWARD C WAGNER DMD
2031 E HOSPITALTIY LN STE 100
BOISE, ID 83716
Phone number: 208-333-9999
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Mailing Address
-- EDWARD C WAGNER DMD
2031 E HOSPITALTIY LN STE 100
BOISE, ID 83716
Phone number: 208-333-9999
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