MATTHEW ROBERT WAGNER DMD NPI 1578052866

NPI Information

NPI: 1578052866
Provider Name: MATTHEW ROBERT WAGNER, DMD
Classification: Dentist - 1223G0001X
Entity Type: Individual

Specialization: General Practice

Address:
2830 CURRY LN #1
GREEN BAY, WI
ZIP 54311
Phone: (920) 432-7230
Get Directions

Matthew Robert Wagner, DMD is a general practice dentist in Green Bay, WI. 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. Matthew Robert Wagner, DMD NPI is 1578052866. 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:

2830 CURRY LN #1
GREEN BAY, WI
ZIP 54311
Phone: (920) 432-7230

The enumeration date for this NPI number is 5/2/2018 and was last updated on 5/2/2018.

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	1223G0001X	Dentist	General Practice	1001719-15	WISCONSIN	Yes
2	1223G0001X	Dentist	General Practice	22736	FLORIDA	No

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: 4/28/2024

NPI Synchronization or Removal

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