Mary June Asenathe Wagner in Palo Alto - General Practice
Mary June Asenathe Wagner - NPI 1578761631
Mary June Asenathe Wagner is a General Practice in Palo Alto, California. Mary June Asenathe Wagner practices all healthcare services and medical treatments related to General Practice. The NPI Number for Mary June Asenathe Wagner is 1578761631. The last update date is 2012-09-28.
Mary June Asenathe Wagner's current location address is 1795 El Camino Real #100, Palo Alto, California. You can contact this provider via phone number 6503281223 and fax number 6503278903. The mailing address for Mary June Asenathe Wagner is 1795 El Camino Real #100, Palo Alto, California. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Mary June Asenathe Wagner |
|---|---|
| Address | 1795 El Camino Real #100, Palo Alto, California |
| Phone Number | 6503281223 |
| Fax Number | 6503278903 |
| Sole Proprietor | N |
| Credentials | D.D.S. |
NPI Number Detail
| NPI Number | 1578761631 |
|---|---|
| Provider Enumeration Date | 2007-07-10 |
| Last Updated Date | 2012-09-28 |
Provider Mailing Address Detail
| Address | 1795 El Camino Real #100 |
|---|---|
| City | Palo Alto |
| State | California (CA) |
| Post Code | 94306 |
| Phone Number | 6503281223 |
| Fax Number | 6503278903 |
Provider's Primary Taxonomy Detail
| Speciality | General Practice |
|---|---|
| Taxonomy | 1223G0001X |
| Licence No | 46779 |
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Definition: A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs. |
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What is the Mary June Asenathe Wagner's unique identification number?
The Mary June Asenathe Wagner has been assigned the NPI (National Provider Identifier) Number 1578761631 by the Centers for Medicare & Medicaid Services (CMS). This 10-digit code serves as a unique identifier for the organization.
Could you share the physical location details of Mary June Asenathe Wagner?
The Mary June Asenathe Wagner is situated at 1795 El Camino Real #100, in the city of Palo Alto, state of CA, with the zip code 94306.
What is Mary June Asenathe Wagner's area of specialization, and what is the corresponding taxonomy classification code for this field of practice?
The specialized area of practice for Mary June Asenathe Wagner is General Practice, and the taxonomy code that categorizes this field of expertise is 1223G0001X.
On what date did the Mary June Asenathe Wagner receive the assignment of its 1578761631 from the Centers for Medicare & Medicaid Services?
The Mary June Asenathe Wagner was issued its 1578761631 by the Centers for Medicare & Medicaid Services on 2007-07-10.
As of what date were the details related to Mary June Asenathe Wagner most recently updated or revised?
The information pertaining to Mary June Asenathe Wagner, including its address, specialty, and other relevant details, was last updated or revised on 2012-09-28.