Jamison Jenkins Wagner, DDS Valid NPI
Individual provider · Dentist · Stansbury Park, UT
- NPI
- 1831881697
- Type
- Individual (Type 1)
- Primary specialty
- Dentist
- Specialty group
- Dental Providers
- Taxonomy code
- 122300000X
- License number
- 13420053-9921 (UT)
- Sex
- Male
- Sole proprietor
- No
- Enumerated
- 2023-05-22
- Last updated
- 2023-05-22
Practice location
263 Country Clb Ste 103
Stansbury Park, UT 84074-9602
(801) 918-0960