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F John Wagner
Dental Clinic/Center in Lake, Michigan
NPI 1568522910

F John Wagner is a Dental Clinic/Center based in Lake, MI and is specialized in Dental. F John Wagner practices in Lake, MI. The NPI Number for F John Wagner is 1568522910 and holds a License No. 10266 (Michigan).

The current practice location address for F John Wagner is 7791 Mystic Lake Dr, Lake, MI and can be reached out via phone at 989-544-2096.

Location: 7791 Mystic Lake Dr, Lake, MI, 48632-9743
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1568522910
Provider Name
F John Wagner
Credential
Provider Entity Type
Organization
Address
7791 Mystic Lake Dr, Lake, MI, 48632-9743
Phone Number
989-544-2096
Fax Number
Provider Enumeration Date
12/08/2006
Last Update Date
03/08/2024
institution
Provider Business Practice Location Address Details
Address
7791 Mystic Lake Dr
City
Lake
State
Michigan
Zip
48632-9743
Phone Number
989-544-2096
Fax Number
person
Provider Business Mailing Address Details
Address
7791 Mystic Lake Dr
City
Lake
State
Michigan
Zip
48632-9743
Phone Number
989-544-2096
Fax Number
person
Provider's Taxonomy Details 1
Type
Ambulatory Health Care Facilities
Classification
Clinic/Center
Speciality
Dental
Taxonomy
261QD0000X
License No.
10266 (Michigan)
Definition
Definition to come...
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