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1912017302
WAGNER DE LUCA FARIA
SAN BERNARDINO, CA
NPI
1912017302
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
1223G0001X Dentist, General Practice
(Licence: CA 44169)
Enumeration Date
2006-08-30
Last Update Date
2017-01-20
Business Address
Dr. WAGNER DE LUCA FARIA DDS
143 N PLYMOUTH WAY
SAN BERNARDINO, CA 92408-4173
Phone number: 909-533-4139
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Mailing Address
Dr. WAGNER DE LUCA FARIA DDS
143 N PLYMOUTH WAY
SAN BERNARDINO, CA 92408-4173
Phone number: 909-533-4139
Copy
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