Individual provider · Type 1 NPI

Bouakeo Wagner, R.D.H.

Dental Hygienist · Salem, OR

NPI number 1386731792 Active

Practice location

190 Kingwood Ave NW
Salem, OR 97304-4030

Fax (503) 315-0721

Mailing address

14670 SE Salmon St
Portland, OR 97233-2568

Specialties and licenses

TaxonomyCodeLicense
Dental Hygienist Primary 124Q00000XH4345 (OR)

Dental Hygienist: An individual who has completed an accredited dental hygiene education program, and an individual who has been licensed by a state board of dental examiners to provide preventive care services under the supervision of a dentist. Functions that may be legally delegated to the dental hygienist vary based on the needs of the dentist, the educational preparation of the dental hygienist and state dental practice acts and…

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About NPI 1386731792

Bouakeo Wagner, R.D.H.'s National Provider Identifier is 1386731792, issued on Oct 6, 2006. The primary taxonomy on file is Dental Hygienist (124Q00000X), and the practice location is in Salem, OR. The record was last updated on Jul 8, 2007.