DoctorDataHub
Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

DR. TARA MARIE WAGNER, DDS

Active

DR. TARA MARIE WAGNER, DDS is a Dentist healthcare provider located in WHITE BEAR LAKE, Minnesota. NPI 1396840559 is currently active in the NPPES registry. Verify at CMS.

Dentist · WHITE BEAR LAKE, MN

Registration Details

NPI Number
1396840559
Provider Type
Individual
Gender
Female
NPI Issued
Sep 13, 2006 (19.743392480095 yrs)
Last Updated
Jul 8, 2007
License
D11791 (MN)

Practice Information

Address
4700 WHITE BEAR PARKWAY
WHITE BEAR LAKE, MN, 551103336
Browse MN providers · Browse ZIP 55110
Phone
6517627677
Fax
6517621861
Primary Specialty
Dentist
122300000X

Other Dentist Providers in WHITE BEAR LAKE, MN

Name Credential NPI
DR. CARL WILLIAM RINDELAUB DDS 1386730901
DR. PAUL DANIEL ANDERSON DDS 1659449098
DR. SARAH ELIZABETH BOO DDS 1821148347
DR. GEETHA J DAMODARAN D.D.S. 1275858078
DR. TYLER J KOIVISTO DDS 1588002430
SHVETA SETIA DDS 1730595729
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.