| Kent Wagner Jr Dds Pc | |
|
2045 Village Center Circle Las Vegas NV 89134 | |
| (702) 878-5599 | |
| (702) 878-0173 |
| Full Name | Kent Wagner Jr Dds Pc |
|---|---|
| Speciality | Dentist |
| Location | 2045 Village Center Circle, Las Vegas, Nevada |
| Authorized Official Name and Position | Ronald Kent Wagner (DENTIST OWNER) |
| Authorized Official Contact | 7028785599 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Kent Wagner Jr Dds Pc 2045 Village Center Circle Las Vegas NV 89134 Ph: (702) 878-5599 | Kent Wagner Jr Dds Pc 2045 Village Center Circle Las Vegas NV 89134 Ph: (702) 878-5599 |
| NPI Number | 1336157270 |
|---|---|
| Provider Enumeration Date | 08/04/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1336157270 | NPI | - | NPPES |
| 1779641 | Other | UNITED CONCORIDA PROVIDER |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 4799 (Nevada) | Primary |
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