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General NPI Number Information
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NPI Number | 1801400106
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Entity Type | Individual
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Provider Name | SAMANTHA WAGLER D.D.S.
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Gender | Female
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Dates
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Enumeration Date | 09/03/2020
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Last Update Date | 10/27/2021
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Provider Practice Location Address
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Address Line | 80 HUFF AVE SUITE 1
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City | GREENSBURG
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State | PA
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Zip | 15601
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Country | US
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Telephone | 724-836-3368
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Fax | 724-836-1209
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Provider Business Mailing Address
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Address Line | 80 HUFF AVE SUITE 1
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City | GREENSBURG
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State | PA
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Zip | 15601
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Country | US
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Telephone | 724-836-3368
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Fax | 724-836-1209
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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 | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 09822
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License Number State | IA
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Taxonomy #2
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | DS043383
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License Number State | PA
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