Richard W Wagner, DDS MS Valid NPI

Individual provider · Orthodontics and Dentofacial Orthopedics Dentistry · Sioux City, IA

NPI

1710050893

Type

Individual (Type 1)

Primary specialty

Orthodontics and Dentofacial Orthopedics Dentistry (Dentist)

Specialty group

Dental Providers

Taxonomy code

1223X0400X

License number

6637 (IA)

Sex

Male

Sole proprietor

No

Enumerated

2006-11-16

Last updated

2007-07-08