| Doctor Name: | JON DAGLEY WAGNER |
| NPI Number: | 1154338101 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | MD DDS |
| License Number: | 95-367 |
| Business Practice Address: | 10000 Coors Byp Nw Suite G-218 Albuquerque, NM - 871144040 |
| Business Phone Number: | 5052424867 |
| Business Fax Number: | |
| Mailing Address: | 10000 Coors Byp Nw, Suite G-218 ALBUQUERQUE |
| State: | NM |
| Postal Code: | 871144040 |
| Phone Number: | 5052424867 |
| Fax Number: | |
| NPI Enumeration Date: | 08/02/2006 |
| NPI Last Update Date: | 04/04/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208200000X |
| License Number: | 95-367 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | TX |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | Plastic Surgery |
| Taxonomy Specialization: | |
| Taxonomy Definition: | A plastic surgeon deals with the repair, reconstruction or replacement of physical defects of form or function involving the skin, musculoskeletal system, craniomaxillofacial structures, hand, extremities, breast and trunk and external genitalia or cosmetic enhancement of these areas of the body. Cosmetic surgery is an essential component of plastic surgery. The plastic surgeon uses cosmetic surgical principles to both improve overall appearance and to optimize the outcome of reconstructive procedures. The surgeon uses aesthetic surgical principles not only to improve undesirable qualities of normal structures but in all reconstructive procedures as well. |