Individual
E. MARK WADE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
1121 S GILBERT RD STE 104, MESA, AZ 85204-5235
(480) 926-7363
Mailing address
1121 S GILBERT RD STE 104, MESA, AZ 85204-5235
(480) 926-7363
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
3277
AZ
Other
Enumeration date
06/28/2007
Last updated
07/08/2007
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