Wagoner, Alexis Dawn
Wagoner, Alexis Dawn is an sole proprietor health care provider with primary practice located at 3902 Cottonwood St , Longview WA 98632-4911. She recently has only one registered license in Dental Providers / Dental Assistant, which is considered as her primary health care specialty. Wagoner, Alexis Dawn can be contacted via phone (360) 425-7753.Contact Information
Primary practice address
3902 Cottonwood St
Longview WA 98632-4911
Phone: (360) 425-7753
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / Dental Assistant | 126800000X | Washington |
Profile Details
| NPI number | 1083700231 |
|---|---|
| LBN Legal business name | Wagoner, Alexis Dawn |
| Credentials | DA |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Oct 5th, 2006 |
| Last updated | Jul 8th, 2007 - about 18 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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