| Spencer B Wagner Dmd Pc | |
|
1987 Allendale Fairfax Hwy Fairfax SC 29827-9137 | |
| (803) 632-3301 | |
| (803) 632-1240 |
| Full Name | Spencer B Wagner Dmd Pc |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 1987 Allendale Fairfax Hwy, Fairfax, South Carolina |
| Authorized Official Name and Position | Spencer B Wagner (DENTIST) |
| Authorized Official Contact | 8036323301 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Spencer B Wagner Dmd Pc Po Box 830 Fairfax SC 29827-0830 Ph: (803) 632-3301 | Spencer B Wagner Dmd Pc 1987 Allendale Fairfax Hwy Fairfax SC 29827-9137 Ph: (803) 632-3301 |
| NPI Number | 1205897378 |
|---|---|
| Provider Enumeration Date | 03/29/2006 |
| Last Update Date | 10/07/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1205897378 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | 3192 (South Carolina) | Primary |
Welvista Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 3269 Allendale Fairfax Hwy, Fairfax, SC 29827 Phone: 803-584-4803 Fax: 803-584-4806 | |
Robert M. Haberkorn Dds Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 1987 Allendale Fairfax Hwy., Fairfax, SC 29827 Phone: 803-632-3301 |