Most Relevant Information
Provider Data
| NPI Number: | 1003044173 |
| Provider Name: | STEPHEN THOMAS WAGNER DDS |
| Entity Type: | Individual |
| Taxonomy Code: | 1223G0001X |
| Specialty: | Dentist |
| License Number: | 14543 |
Most Important Dates
| Enumeration Date: | 06/29/2009 |
| Last Updated: | 01/25/2010 |
Provider Practice Location
12137 ELM ST
PRINCESS ANNE
MD
218531358
Practice Location Phone/Fax
| Phone: | 4106515151 |
| Fax: | 4106514256 |
Provider Mailing Location
PO BOX 1978
SALISBURY
MD
218021978
Provider Mailing Phone/Fax
| Phone: | 4107491015 |
| Fax: | 4107490654 |