Individual provider · Type 1 NPI

Brandon Mark Wagner, DDS

General Practice Dentistry · Boise, ID

NPI number 1265002901 Active

Practice location

403 S 11th St Ste 200
Boise, ID 83702-6968

Call (208) 342-3440 Map

Specialties and licenses

TaxonomyCodeLicense
General Practice Dentistry Primary 1223G0001XD-5306 (ID)

General Practice Dentistry: A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.

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About NPI 1265002901

Brandon Mark Wagner, DDS's National Provider Identifier is 1265002901, issued on Jun 25, 2021. The primary taxonomy on file is General Practice Dentistry (1223G0001X), and the practice location is in Boise, ID. The record was last updated on Sep 8, 2025.