Jennifer Van Wagoner, DMD
NPI 1396974572 · on the registry since 2009 · sole proprietor
Practice
- Address
- 35401 Mission Dr
St. Ignatius, MT 59865 - Phone
- (406) 745-3525
- Fax
- (406) 745-3529
- Clinicians at this address
- 19
Registry record
- Primary taxonomy
- Dentist
122300000X
- Also registered as
- General Practice Dentistry
- Licence states on file
- NV
From the registry's licence fields, which are often incomplete.
- Sex
- Female
- Record last updated
- 2014-10-17
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 Montana