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Search › New Mexico › 1223S0112X

Jon Wagner, MD DDS

NPI 1154338101 · on the registry since 2006

Practice

Address
10000 Coors Byp Nw
Suite G-218
Albuquerque, NM 87114
Phone
(505) 242-4867
Organisation at this address
Trifecta Light Center Llc
Lilly'S Internal Light, Llc
Nm Transformative Therapy Llc
Luxottica Retail North America Inc
Cottonwood Mall Dental Practice, Llc
Inferred from a shared address, not stated in the registry.
Clinicians at this address
15

Registry record

Primary taxonomy
1223S0112X
1223S0112X
Also registered as
208200000X
1223S0112X
1223S0112X
Licence states on file
TX, NM, NY
From the registry's licence fields, which are often incomplete.
Sex
Male
Record last updated
2013-04-04

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in New Mexico