WAGNER DE LUCA FARIA

SAN BERNARDINO, CA
NPI1912017302
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy1223G0001X Dentist, General Practice
(Licence: CA  44169)
Enumeration Date2006-08-30
Last Update Date2017-01-20
Business Address
Dr. WAGNER DE LUCA FARIA DDS
143 N PLYMOUTH WAY
SAN BERNARDINO, CA 92408-4173
Phone number: 909-533-4139
Mailing Address
Dr. WAGNER DE LUCA FARIA DDS
143 N PLYMOUTH WAY
SAN BERNARDINO, CA 92408-4173
Phone number: 909-533-4139