| Lehman Waggener Professional Dental Corporation | |
|
80 Doctors Park Drive Santa Rosa CA 95405 | |
| (707) 544-1836 | |
| (707) 542-0617 |
| Full Name | Lehman Waggener Professional Dental Corporation |
|---|---|
| Speciality | Dentist - Periodontics |
| Location | 80 Doctors Park Drive, Santa Rosa, California |
| Authorized Official Name and Position | Kelly Johanna Waggener (PRESIDENT) |
| Authorized Official Contact | 7075383325 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Lehman Waggener Professional Dental Corporation 80 Doctors Park Drive Santa Rosa CA 95405 Ph: (707) 544-1836 | Lehman Waggener Professional Dental Corporation 80 Doctors Park Drive Santa Rosa CA 95405 Ph: (707) 544-1836 |
| NPI Number | 1174664460 |
|---|---|
| Provider Enumeration Date | 02/09/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1174664460 | NPI | - | NPPES |
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