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General NPI Number Information
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NPI Number | 1598763443
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Entity Type | Individual
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Provider Name | NICHOLAS STEVEN WAAGE DDS
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Gender | Male
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Dates
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Enumeration Date | 07/13/2005
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Last Update Date | 01/25/2011
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Provider Practice Location Address
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Address Line | 64 E HICKMAN ROAD
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City | WAUKEE
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State | IA
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Zip | 50263
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Country | US
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Telephone | 515-987-1155
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Fax | 515-987-1181
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Provider Business Mailing Address
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Address Line | 64 E HICKMAN ROAD
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City | WAUKEE
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State | IA
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Zip | 50263
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Country | US
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Telephone | 515-987-1155
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Fax | 515-987-1181
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number | 08555
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License Number State | IA
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