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Individual
SHERNIQUE WALLACE
Active
Individual
SHERNIQUE WALLACE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DDS
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
33849
TX
390200000X
Student in an Organized Health Care Education/Training Program
059085-1
NY
Other
Enumeration date
03/27/2015
Last updated
06/06/2019
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