| Rudolph M. Wagner, Dmd, Pllc | |
|
2595 Tampa Rd Ste I Palm Harbor FL 34684-3131 | |
| (727) 785-8847 | |
| Not Available |
| Full Name | Rudolph M. Wagner, Dmd, Pllc |
|---|---|
| Speciality | Dentist - Orthodontics And Dentofacial Orthopedics |
| Location | 2595 Tampa Rd Ste I, Palm Harbor, Florida |
| Authorized Official Name and Position | Rudolph Wagner (ORTHODONTIST/ MANAGING MEMBER) |
| Authorized Official Contact | 7277858847 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Rudolph M. Wagner, Dmd, Pllc 2595 Tampa Rd Ste I Palm Harbor FL 34684-3131 Ph: (727) 785-8847 | Rudolph M. Wagner, Dmd, Pllc 2595 Tampa Rd Ste I Palm Harbor FL 34684-3131 Ph: (727) 785-8847 |
| NPI Number | 1679146435 |
|---|---|
| Provider Enumeration Date | 07/20/2021 |
| Last Update Date | 07/20/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1679146435 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223X0400X | Dentist - Orthodontics And Dentofacial Orthopedics | (* (Not Available)) | Primary |
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