SPENCER B WAGNER DMD PC NPI 1205897378

NPI Information

NPI: 1205897378
Provider Name: SPENCER B WAGNER DMD PC
Classification: Clinic/Center - 261QD0000X
Entity Type: Organization

Specialization: Dental

Address:
1987 ALLENDALE FAIRFAX HWY
FAIRFAX, SC
ZIP 29827
Phone: (803) 632-3301
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SPENCER B WAGNER DMD PC is a dental clinic center in Fairfax, SC. SPENCER B WAGNER DMD PC NPI is 1205897378. The provider is registered as an organization entity type.

The provider's business location address is:

1987 ALLENDALE FAIRFAX HWY
FAIRFAX, SC
ZIP 29827-137
Phone: (803) 632-3301
Fax: (803) 632-1240

The provider's authorized official is Spencer B Wagner .
The authorized official title is Dentist and has the following contact phone number (803) 632-3301.

The enumeration date for this NPI number is 3/29/2006 and was last updated on 10/7/2008.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QD0000X	Clinic/Center	Dental	3192	SOUTH CAROLINA	Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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