Wagner, Charles Allen

Wagner, Charles Allen is an individual health care provider with primary practice located at 773 Golf View Dr , Medford OR 97504-9643. He recently has only one registered license in Dental Providers / General Practice, which is considered as his primary health care specialty. Wagner, Charles Allen can be contacted via phone (541) 857-2790.

Contact Information

Primary practice address
773 Golf View Dr Medford OR 97504-9643
Phone: (541) 857-2790
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / General Practice 1223G0001X D7442 Oregon

Profile Details

NPI number 1982760153
LBN Legal business name Wagner, Charles Allen
Credentials Doctor of Dental Surgery (DDS)
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 29th, 2006
Last updated Jun 4th, 2015 - about 10 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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