Wagoner, Joel M

Wagoner, Joel M is an sole proprietor health care provider with primary practice located at 77 Vilcom Center Dr Suite 110, Chapel Hill NC 27514-1598. He recently has only one registered license in Dental Providers / General Practice, which is considered as his primary health care specialty. Wagoner, Joel M can be contacted via phone (919) 968-9697.

Contact Information

Primary practice address
77 Vilcom Center Dr Suite 110 Chapel Hill NC 27514-1598
Fax: (919) 942-3331
Website:

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / General Practice 1223G0001X 4126 North Carolina

Profile Details

NPI number 1982607826
LBN Legal business name Wagoner, Joel M
Credentials Doctor of Dental Surgery (DDS)
Entity Individual
Sole proprietor 1 Yes
Enumeration date May 24th, 2005
Last updated Dec 9th, 2010 - about 14 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 1982607826 NPPES
North Carolina Other 535847 UCCI
North Carolina Other 9015X UCCI
North Carolina MEDICAID 899015X UCCI
North Carolina Other 464231 UCCI

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