Wagner, Jon Dagley

Wagner, Jon Dagley is an individual health care provider with primary practice located at 10000 Coors Byp Nw Suite G-218, Albuquerque NM 87114-4040. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Plastic Surgery, Dental Providers / Oral and Maxillofacial Surgery. Dental Providers / Oral and Maxillofacial Surgery is his primary health care specialty. Wagner, Jon Dagley can be contacted via phone (505) 242-4867.

Contact Information

Primary practice address
10000 Coors Byp Nw Suite G-218 Albuquerque NM 87114-4040
Phone: (505) 242-4867
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Plastic Surgery 208200000X 95-367 Texas
Dental Providers / Oral and Maxillofacial Surgery 1223S0112X DD3842 New Mexico
Dental Providers / Oral and Maxillofacial Surgery 1223S0112X 28634 Texas
Dental Providers / Oral and Maxillofacial Surgery 1223S0112X 055441-1 New York

Profile Details

NPI number 1154338101
LBN Legal business name Wagner, Jon Dagley
Credentials MD DDS
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 2nd, 2006
Last updated Apr 4th, 2013 - about 11 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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