Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
DR. JENNIFER VAN WAGONER, DMD
Active Sole ProprietorDR. JENNIFER VAN WAGONER, DMD is a Dentist healthcare provider located in ST. IGNATIUS, Montana. NPI 1396974572 is currently active in the NPPES registry. Verify at CMS.
Dentist · ST. IGNATIUS, MT
Registration Details
- NPI Number
- 1396974572
- Provider Type
- Individual
- Gender
- Female
- NPI Issued
- Jul 8, 2009 (17.091029780774 yrs)
- Last Updated
- Oct 17, 2014
- Licenses
-
5912 (NV)5912 (NV)
- Sole Proprietor
- Yes
Practice Information
- Address
-
35401 MISSION DRST. IGNATIUS, MT, 59865Browse MT providers · Browse ZIP 59865
- Phone
- 4067453525
- Fax
- 4067453529
- Primary Specialty
-
Dentist
122300000X
- Additional Specialty
- Dentist
Other Dentist Providers in ST. IGNATIUS, MT
| Name | Credential | NPI |
|---|---|---|
| DR. STEPHANIE PENTURF SHEALY | DDS | 1326295759 |
| TANNER L. DIGGS | DENTIST | 1508247578 |
| DR. SARIN MCKENNA | DMD | 1700257474 |
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.