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Dr. Richard M Wagner, DDS
Oral and Maxillofacial Surgery (Dentist) in Racine, Wisconsin
NPI 1770700957

Richard M Wagner is a Oral and Maxillofacial Surgery (Dentist) based in Racine, WI and is specialized in Oral and Maxillofacial Surgery. Richard M Wagner practices in Racine, WI and has the professional credentials of DDS. The NPI Number for Richard M Wagner is 1770700957 and holds a License No. 3092 (Wisconsin).

The current practice location address for Richard M Wagner is 1925 South Green Bay Rd, Racine, WI and can be reached out via phone at 262-634-4646 and via fax at 262-634-4694.

Location: 1925 South Green Bay Rd, Racine, WI, 53406-4654
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1770700957
Provider Name
Richard M Wagner
Credential
DDS
Provider Entity Type
Individual
Gender
Male
Address
1925 South Green Bay Rd, Racine, WI, 53406-4654
Phone Number
262-634-4646
Fax Number
262-634-4694
Provider Enumeration Date
04/19/2007
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
33491300 05 WI
institution
Provider Business Practice Location Address Details
Address
1925 South Green Bay Rd
City
Racine
State
Wisconsin
Zip
53406-4654
Phone Number
262-634-4646
Fax Number
262-634-4694
person
Provider Business Mailing Address Details
Address
1925 South Green Bay Rd
City
Racine
State
Wisconsin
Zip
53406-4654
Phone Number
262-634-4646
Fax Number
262-634-4694
person
Provider's Taxonomy Details 1
Type
Dental Providers
Classification
Dentist
Speciality
Oral and Maxillofacial Surgery
Taxonomy
1223S0112X
License No.
3092 (Wisconsin)
Definition
The specialty of dentistry which includes the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region.
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