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
Phone: (919) 968-9697
Fax: (919) 942-3331
Website:
Health care specialties
| Specialty | Code | License # | 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 15 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 | 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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