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Dr. Elyse Anne Wagner, DMD
Prosthodontist in Newton Centre, Massachusetts
NPI 1023509007

Elyse Anne Wagner is a Prosthodontist based in Newton Centre, MA and is specialized in Prosthodontics. Elyse Anne Wagner practices in Newton Centre, MA and has the professional credentials of DMD. The NPI Number for Elyse Anne Wagner is 1023509007 and holds a License No. (Massachusetts).

The current practice location address for Elyse Anne Wagner is 93 Union St Ste 402, Newton Centre, MA and can be reached out via phone at 179-650-0606.

Location: 93 Union St Ste 402, Newton Centre, MA, 02459-2241
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1023509007
Provider Name
Elyse Anne Wagner
Credential
DMD
Provider Entity Type
Individual
Gender
Female
Address
93 Union St Ste 402, Newton Centre, MA, 02459-2241
Phone Number
179-650-0606
Fax Number
Provider Enumeration Date
05/24/2018
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
93 Union St Ste 402
City
Newton Centre
State
Massachusetts
Zip
02459-2241
Phone Number
179-650-0606
Fax Number
person
Provider Business Mailing Address Details
Address
93 Union St Ste 402
City
Newton Centre
State
Massachusetts
Zip
02459-2241
Phone Number
179-650-0606
Fax Number
person
Provider's Taxonomy Details 1
Type
Dental Providers
Classification
Dentist
Speciality
Prosthodontics
Taxonomy
1223P0700X
License No.
DN1858351 (Massachusetts)
Definition
That branch of dentistry pertaining to the restoration and maintenance of oral functions, comfort, appearance and health of the patient by the restoration of natural teeth and/or the replacement of missing teeth and contiguous oral and maxillofacial tissues with artificial substitutes.
person
Provider's Taxonomy Details 2
Type
Student, Health Care
Classification
Student in an Organized Health Care Education/Training Program
Speciality
-
Taxonomy
390200000X
License No.
()
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
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