Wagner, Stephen A.
Wagner, Stephen A. is an sole proprietor health care provider with primary practice located at 801 Encino Pl Ne Suite A-3, Albuquerque NM 87102-2612. He recently has only one registered license in Dental Providers / Prosthodontics, which is considered as his primary health care specialty. Wagner, Stephen A. can be contacted via phone (505) 232-3588.Contact Information
Primary practice address
801 Encino Pl Ne Suite A-3
Albuquerque NM 87102-2612
Phone: (505) 232-3588
Fax: (505) 232-3593
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / Prosthodontics | 1223P0700X | 1150 | New Mexico |
Profile Details
| NPI number | 1336131267 |
|---|---|
| LBN Legal business name | Wagner, Stephen A. |
| Credentials | Doctor of Dental Surgery (DDS) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Aug 17th, 2005 |
| Last updated | Apr 30th, 2014 - 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1336131267 | NPPES |
| New Mexico | MEDICAID | 82743 |
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