Wagner, Tara Marie
Wagner, Tara Marie is an individual health care provider with primary practice located at 4700 White Bear Parkway , White Bear Lake MN 55110-3336. She recently has only one registered license in Dental Providers / Dentist, which is considered as her primary health care specialty. Wagner, Tara Marie can be contacted via phone (651) 762-7677.Contact Information
Primary practice address
4700 White Bear Parkway
White Bear Lake MN 55110-3336
Phone: (651) 762-7677
Fax: (651) 762-1861
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / Dentist | 122300000X | D11791 | Minnesota |
Profile Details
| NPI number | 1396840559 |
|---|---|
| LBN Legal business name | Wagner, Tara Marie |
| Credentials | Doctor of Dental Surgery (DDS) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Sep 13th, 2006 |
| Last updated | Jul 8th, 2007 - about 19 years 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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