Individual
MONICA LATRICE WADE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
44558 10TH STREET WEST, LANCASTER, CA 93534
(310) 820-9933
Mailing address
3260 VIANA DR., PALMDALE, CA 93550
(661) 267-0793
Taxonomy
Speciality
Code
Description
License number
State
126800000X
Dental Assistant
Primary
68982
CA
Other
Enumeration date
09/10/2009
Last updated
09/10/2009
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