| David A Wagner Dds | |
|
3023 Eastland Blvd Suite 112 Clearwater FL 33761-4106 | |
| (727) 797-5161 | |
| (727) 797-5121 |
| Full Name | David A Wagner Dds |
|---|---|
| Speciality | Dentist |
| Location | 3023 Eastland Blvd, Clearwater, Florida |
| Authorized Official Name and Position | David Alan Wagner (OWNER/DENTIST) |
| Authorized Official Contact | 7277975161 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| David A Wagner Dds 3023 Eastland Blvd Suite 112 Clearwater FL 33761-4106 Ph: (727) 797-5161 | David A Wagner Dds 3023 Eastland Blvd Suite 112 Clearwater FL 33761-4106 Ph: (727) 797-5161 |
| NPI Number | 1952855470 |
|---|---|
| Provider Enumeration Date | 08/12/2016 |
| Last Update Date | 02/28/2017 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1952855470 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | DN13625 (Florida) | Primary |
| 332BC3200X | Durable Medical Equipment & Medical Supplies - Customized Equipment | DN13625 (Florida) | Secondary |
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