Wagoner, Eric James

Wagoner, Eric James is an sole proprietor health care provider with primary practice located at 835 Wake Forest Business Park Ste E , Wake Forest NC 27587-7324. He recently has only one registered license in Dental Providers / General Practice, which is considered as his primary health care specialty. Wagoner, Eric James can be contacted via phone (919) 570-7930.

Contact Information

Primary practice address
835 Wake Forest Business Park Ste E Wake Forest NC 27587-7324
Phone: (919) 570-7930
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / General Practice 1223G0001X 9367 North Carolina

Profile Details

NPI number 1750633483
LBN Legal business name Wagoner, Eric James
Credentials Doctor of Dental Surgery (DDS)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Oct 4th, 2012
Last updated Jul 21st, 2022 - about 2 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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Identifiers

StateTypeNumberIssuer
All States NPI 1750633483 NPPES
North Carolina MEDICAID 5921749

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