Richard M Wagner in Racine - Oral And Maxillofacial Surgery
Richard M Wagner - NPI 1770700957
Richard M Wagner is a Oral And Maxillofacial Surgery in Racine, Wisconsin. Richard M Wagner practices all healthcare services and medical treatments related to Oral And Maxillofacial Surgery. The NPI Number for Richard M Wagner is 1770700957. The last update date is 2007-07-08.
Richard M Wagner's current location address is 1925 South Green Bay Rd, Racine, Wisconsin. You can contact this provider via phone number 2626344646 and fax number 2626344694. The mailing address for Richard M Wagner is 1925 South Green Bay Rd, Racine, Wisconsin. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Richard M Wagner |
|---|---|
| Address | 1925 South Green Bay Rd, Racine, Wisconsin |
| Phone Number | 2626344646 |
| Fax Number | 2626344694 |
| Sole Proprietor | N |
| Credentials | DDS |
NPI Number Detail
| NPI Number | 1770700957 |
|---|---|
| Provider Enumeration Date | 2007-04-19 |
| Last Updated Date | 2007-07-08 |
Provider Mailing Address Detail
| Address | 1925 South Green Bay Rd |
|---|---|
| City | Racine |
| State | Wisconsin (WI) |
| Post Code | 534064654 |
| Phone Number | 2626344646 |
| Fax Number | 2626344694 |
Provider's Primary Taxonomy Detail
| Speciality | Oral And Maxillofacial Surgery |
|---|---|
| Taxonomy | 1223S0112X |
| Licence No | 3092 |
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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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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 33491300 | WI | -- |
Post Comment/ Review Below
What is the unique identifier code issued to Richard M Wagner by the Centers for Medicare & Medicaid Services (CMS)?
The Richard M Wagner has been assigned the NPI (National Provider Identifier) 1770700957. This 10-digit code serves as a unique identification number for healthcare providers, issued by the CMS.
Could you kindly provide the complete physical address where Richard M Wagner's facilities are geographically located?
The facilities of Richard M Wagner are physically situated at the following location: 1925 South Green Bay Rd, Racine, WI, 534064654.
What is the Richard M Wagner's specialty and taxonomy code?
The Richard M Wagner's specialty is Oral And Maxillofacial Surgery, and the corresponding taxonomy code is 1223S0112X.
On what date did the Richard M Wagner receive its 1770700957 assignment from the Centers for Medicare & Medicaid Services?
The Richard M Wagner was assigned its 1770700957 by the Centers for Medicare & Medicaid Services on 2007-04-19.
As of what date were the details related to Richard M Wagner most recently updated or revised?
The information pertaining to Richard M Wagner, including its address, specialty, and other relevant details, was last updated or revised on 2007-07-08.