| Wagner, Kuntz & Grabouski | |
|
3021 Hamilton Blvd Sioux City IA 51104-2407 | |
| (712) 258-0501 | |
| (712) 258-1461 |
| Full Name | Wagner, Kuntz & Grabouski |
|---|---|
| Speciality | Dentist - Orthodontics And Dentofacial Orthopedics |
| Location | 3021 Hamilton Blvd, Sioux City, Iowa |
| Authorized Official Name and Position | Richard Wagner (ORTHODONTIST) |
| Authorized Official Contact | 7122580501 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Wagner, Kuntz & Grabouski 3021 Hamilton Blvd Sioux City IA 51104-2407 Ph: (712) 258-0501 | Wagner, Kuntz & Grabouski 3021 Hamilton Blvd Sioux City IA 51104-2407 Ph: (712) 258-0501 |
| NPI Number | 1043402894 |
|---|---|
| Provider Enumeration Date | 08/15/2007 |
| Last Update Date | 08/15/2007 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1043402894 | NPI | - | NPPES |
| 10025343600 | Medicaid | NE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223X0400X | Dentist - Orthodontics And Dentofacial Orthopedics | 6637 (Iowa) | Primary |
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