-- JON DAGLEY WAGNER -- MD DDS
Individual Provider (NPI-1)
Active
Dentist, Oral and Maxillofacial Surgery
Provider Information
- NPI Number
1154338101- Provider Type
- Individual Provider (NPI-1)
- Credentials
- MD DDS
- Status
- Active
Contact & Location
- Address
- 10000 COORS BYP NW SUITE G-218, ALBUQUERQUE, NM, 871144040
- Phone
- (505) 242-4867
Specialties & Taxonomies
Plastic Surgery
License: TX #95-367
Dentist, Oral and Maxillofacial Surgery
Primary License: NM #DD3842
Dentist, Oral and Maxillofacial Surgery
License: TX #28634
Dentist, Oral and Maxillofacial Surgery
License: NY #055441-1