| Doctor Name: | DR. CRAIG A WAGLEY |
| NPI Number: | 1235115833 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | DDS MD |
| License Number: | 21078 |
| Business Practice Address: | 5437 Mahoning Ave Suite 12 Austintown, OH - 445152437 |
| Business Phone Number: | 3307922501 |
| Business Fax Number: | 3307929249 |
| Mailing Address: | 5437 Mahoning Ave, Suite 12 AUSTINTOWN |
| State: | OH |
| Postal Code: | 445152437 |
| Phone Number: | 3307922501 |
| Fax Number: | 3307929249 |
| NPI Enumeration Date: | 12/16/2005 |
| NPI Last Update Date: | 02/08/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 204E00000X |
| License Number: | 21078 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | OH |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | Oral & Maxillofacial Surgery |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |