Wagner, Charles Allen
Wagner, Charles Allen is an individual health care provider with primary practice located at 2860 Valencia Dr , Idaho Falls ID 83404-7597. He recently has only one registered license in Dental Providers / General Practice, which is considered as his primary health care specialty. Wagner, Charles Allen can be contacted via phone (855) 433-6825.Contact Information
Primary practice address
2860 Valencia Dr
Idaho Falls ID 83404-7597
Phone: (855) 433-6825
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / General Practice | 1223G0001X | 2971138 | Idaho |
| Dental Providers / General Practice | 1223G0001X | D7442 | Oregon |
Profile Details
| NPI number | 1982760153 |
|---|---|
| LBN Legal business name | Wagner, Charles Allen |
| Credentials | Doctor of Dental Surgery (DDS) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Dec 29th, 2006 |
| Last updated | Jul 29th, 2026 - about 3 months ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
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