DR. Brandon Mark Wagner, DDS is a general practice dentist in Boise, ID. The provider is 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. DR. Brandon Mark Wagner, DDS NPI is 1265002901. The provider is registered as an individual entity type.
The NPPES NPI record indicates the provider is a male.
The provider's business location address is:
403 S 11TH ST STE 200
BOISE, ID
ZIP 83702-968
Phone: (208) 342-3440
The NPI 1265002901 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA).
The enumeration date for this NPI number is 6/25/2021 and was last updated on 5/2/2022.