SearchIdahoDentist

Kevin Wagner, DMD

NPI 1558094508 · on the registry since 2022

Practice

Address
921 S 8th Avenue Stop 8088
Pocatello, ID 83201
Phone
(609) 923-0168
Clinicians at this address
11

Registry record

Primary taxonomy
Dentist
122300000X
Licence states on file
ID
From the registry's licence fields, which are often incomplete.
Sex
Male
Record last updated
2022-07-07

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 Idaho