F John Wagner
F John Wagner is a Dental Clinic/Center in Lake, Michigan. Licensed in Michigan. Registered with an NPI since 2006.
- Licensed in
- MI
- In the registry since
- 2006
Practice location Address checks out
7791 Mystic Lake DrLake, MI 48632-9743
Phone: (989) 544-2096
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Pin is approximate — placed at the ZIP-code centre, not the exact door.
Specialties & licences
| Dental Clinic/Center (primary) | Taxonomy 261QD0000X · Licence 10266 (MI) |
|---|
Record details
| NPI number | 1568522910 |
|---|---|
| Entity type | Organization (Type 2) |
| Organization subpart | No |
| Authorized official | Frederic Wagner — Pres · (989) 544-2096 |
| NPI enumerated | December 8, 2006 |
| Last updated in NPPES | August 22, 2020 |
| Mailing address | 7791 Mystic Lake Dr, Lake, MI 48632-9743 |